Sunday, December 9, 20121214. Follow-up. "Closed pyometra" case
Two days ago, this
11-year-old female Maltese was operated by Dr Daniel and me.
This was a strange case. Total white cell count was very
high in the blood test. A swollen abdomen with a globular
lump. I said it was a very full bladder on first palpation
but Dr Daniel said the dog had peed all urine. An X-ray
showed a big globular swelling and I was quite sure it was
the bladder. Or was it a large uterus filled with pus since
the owner had said that the dog had passed "sticky urine".
Some owners are not very correct with their signs and symptoms of their dog and "stickiness" in urine could be pus being discharged from the infected uterus in this old dog. The owner agreed to X-rays and blood tests. No radio-dense urinary stones were seen but this just meant that the stones would not be visible in the X-rays as not all urinary stones are. The blood tests showed a severe bacterial infection with the dog being toxic.
The next step would be surgery and after 24 hours on an IV drip and medication, the dog was operated by Dr Daniel and myself. Time was of the essence. An old dog was high anaesthetic risk but there was no option other than surgery to resolve the health problem. SURGERY ON DEC 7, 2012 The biggest bladder ever seen. Like 3/4 of a Thai mango. The dog had been given IV drip 12 hours ago to pep her up for surgery and increase her chances of survival. More than 15 cm long. I aspirated the urine with a sterile syringe from the apex of the bladder and sent for urine analysis. You can see that the urine is colourless from the images in this webpage.
  When Dr Daniel tried to pass the catheter out from the neck of the bladder, there was obstruction. "It is possible that there could be a urinary stone stuck inside the short urethra and not visible on the X-ray," I said. After a few attempts, he managed to pass the catheter out of the urethra and the vulval lips. "There could be a urethral obstruction in the female dog as well." There could be urethral spasms as well but I would bet that there was an urethral obstruction. Most vets don't pass the urethral catheter via the vulval vestibule as they deem it difficult to do it, unlike in the dog. Dr Daniel irrigated the bladder with saline and stitched the 1-cm incision with two layers of 3/0 mono-syn sutures. "Check the neck of the bladder for tumours," I said. "Extend the incision of the skin and linea alba caudally. As Dr Daniel pulled up the bladder, we could see a large reddish lump at the neck of the bladder on the outside. I took an image for the owner to see as it was not possible for her to be at the operation room. This swelling of around 8 mm x 8 mm x 4 mm could be the cause of difficulty in urination.
DISCUSSION WITH THE
OWNERS
Today was the first time I met the father and two young adult daughters as Dr Daniel was the vet in charge of the case. "Did the dog have difficulty passing urine?" I asked. "Yes," one daughter said. "She took a long time to pee and only a few drops of urine came out." I reviewed the record on Dec 6 when the dog was admitted. "Urine sticky. Stools red and yellow past 2 weeks. Appetite decreased. Vomited once." Pyometra was suspected but the onset of heat was unknown. In conclusion, there was a case of pyometra and urethral obstruction caused either by a non-radio-dense urinary stone in the urethra or the neck of the bladder tumour. The "urinary stone" was not seen as the urinary catheter appeared in the vulval area as there was flushing of the urethra from inside the bladder before removing the obstruction. Many old intact female dogs do suffer from pyometra and in this case, there was pyometra with the uterine body wall being as thin as a piece of paper, leaking out the bacteria into the blood stream as well as into the bladder, in my observation. Fortunately, the uterine bodies were removed before they ruptured. Similarly for the bladder as it would rupture if the urine could not be passed out, as you can see how thin the wall was, from the images. More than 7 days had passed, now being Dec 16, 2012 as I edit this report. The owners were happy that the dog leads a normal life and has no difficulty in peeing. Two weeks had passed before the owners consulted the vet. Fortunately, the dog did not suffer kidney damage in the delay in seeking treatment and that the appropriate treatment was given. The old dog has a new lease of life. Updates and images will be at: http://www.bekindtopets.com/dogs/20121216dysuria_pyometra_toapayohvets.htm UPDATE: Dec 21, 2012. The dog came for stitch removal as there was a slight stitch breakdown in the last stitch nearer to the vagina. Dr Daniel removed the stitches which were absorbable. "There is some sticky dicharge from the vagina," the lady owner said that the dog now could pee normally and was OK. "Most likely the vestibule in the vagina still has some pus left over from the uterus," I told her. "Since the infected womb has been removed, this pus would disappear soon. There is nothing to worry and is a common occurrence in some post-op cases of dogs with pyometra spayed." In conclusion, the surgical outcome was good and the 11-year-old dog was alive. It would be a happy Christmas for the family. |
Sunday, December 16, 2012
1217. An old female dog had difficulty peeing. Pyometra or urethra obstruction or both?
Friday, December 14, 2012
1215. Are dwarf hamsters dumb?
Yesterday Dec 14, 2012, I spoke to the lady owner about her hamster's tumour below the right ear. Dr Daniel had done electro-excision. For such small tumours and for ear warts, he was not in favour of electro-surgery. A scalpel blade would be just as effective. "No," I told him. But it will take time and patience for me to show that electro-surgery is useful in some hamster tumour excision.
I discovered that Australian vet students don't get lectures on hamsters as nobody in Australia is allowed to keep hamsters as pets! So, a vet graduates without any hamster lectures. This happened to me as a vet student in Glasgow University in 1969-1974. My professors did not mention the "hamster" word too! But in Singapore, many dwarf hamster owners are around although I don't know how many.
I would have taught dwarf hamsters are dumb. But this Indian lady in her 40s told me that she had 3 hamsters and they were clever creatures. Hamster No. 1 was bought 2 years ago against her father's objection of keeping any pets. The older generation of Singaporeans deemed pets as a waste of money when so many people are starving i this world. Yet 2 weeks later, the retiree father was very fond of this hamster. Hamster No. 2 was bought from another place. This hamster was the most intelligent. He would not try to escape or hide under fridges. When placed on the dining table, he would inspect the dishes of the adults and then go to his own plate to eat his food. I saw her mobile phone video of this hamster on the dining table.
Presently, Hamster No. 3 with the tumour on the skin below his right ear. He would show his anger by climbing up the crate's railing and jumping down or refused to come out from his house. For example, if he was not given the correct brand of brand. "He likes only Gardenia," the lady told me. "If I give him another brand, he would go wild and climb up the railings and jump down many times."
The lady continued: "On another occasion when I used the pink colour of the cottony bedding instead of blue, he would scatter the pink ones and would not settle down. I had to go to NEX shopping mall to buy the blue ones."
"Every morning, my sister had to tell him that she is going to work as he rushes out excitedly to greet her," the lady said. "He even knows when my sister is coming back from work as if he has a clock."
"Is he the most intelligent of the 3?" I asked. "No," she said. "Hamster No. 2 was the most intelligent."
Hamster No. 3 would run to hide under the fridge if let to roam free, unlike Hamster No. 2 who harboured no thoughts of escaping under door gaps or into corners. So, I guessed that was why she considered Hamster No. 2 as most intelligent of the 3.
"Do you believe in reincarnation?" I asked.
"Sometimes I think our relatives have been re-incarnated as hamsters."
She could narrate more stories and such stories should be recorded in audio as the flavour of the actions of Hamsters 2 and 3 could not be captured in text.
(LATER)
1. Weight 69 g. The 2nd heaviest in the last 3 days since the black and white one we operated upon was 71 g.
2. Zoletil 50 IM not 100% effective. "Top up with isoflurane gas," I advised.
3. Electrosurgical excision was in <1 bleeding.="bleeding." nbsp="nbsp" no="no" second.="second.">4. A 3rd-year student for 2013 studies from Melbourne Univ was on internsihp for 2 weeks and I have asked her to write about this electrosurgery in the dwarf hamster. The hamster with the ear growth was also operated using electrosurgery.
Website and updates will be done later at www.toapayohvets.com --- goto hamsters.
I discovered that Australian vet students don't get lectures on hamsters as nobody in Australia is allowed to keep hamsters as pets! So, a vet graduates without any hamster lectures. This happened to me as a vet student in Glasgow University in 1969-1974. My professors did not mention the "hamster" word too! But in Singapore, many dwarf hamster owners are around although I don't know how many.
I would have taught dwarf hamsters are dumb. But this Indian lady in her 40s told me that she had 3 hamsters and they were clever creatures. Hamster No. 1 was bought 2 years ago against her father's objection of keeping any pets. The older generation of Singaporeans deemed pets as a waste of money when so many people are starving i this world. Yet 2 weeks later, the retiree father was very fond of this hamster. Hamster No. 2 was bought from another place. This hamster was the most intelligent. He would not try to escape or hide under fridges. When placed on the dining table, he would inspect the dishes of the adults and then go to his own plate to eat his food. I saw her mobile phone video of this hamster on the dining table.
Presently, Hamster No. 3 with the tumour on the skin below his right ear. He would show his anger by climbing up the crate's railing and jumping down or refused to come out from his house. For example, if he was not given the correct brand of brand. "He likes only Gardenia," the lady told me. "If I give him another brand, he would go wild and climb up the railings and jump down many times."
The lady continued: "On another occasion when I used the pink colour of the cottony bedding instead of blue, he would scatter the pink ones and would not settle down. I had to go to NEX shopping mall to buy the blue ones."
"Every morning, my sister had to tell him that she is going to work as he rushes out excitedly to greet her," the lady said. "He even knows when my sister is coming back from work as if he has a clock."
"Is he the most intelligent of the 3?" I asked. "No," she said. "Hamster No. 2 was the most intelligent."
Hamster No. 3 would run to hide under the fridge if let to roam free, unlike Hamster No. 2 who harboured no thoughts of escaping under door gaps or into corners. So, I guessed that was why she considered Hamster No. 2 as most intelligent of the 3.
"Do you believe in reincarnation?" I asked.
"Sometimes I think our relatives have been re-incarnated as hamsters."
She could narrate more stories and such stories should be recorded in audio as the flavour of the actions of Hamsters 2 and 3 could not be captured in text.
(LATER)
1. Weight 69 g. The 2nd heaviest in the last 3 days since the black and white one we operated upon was 71 g.
2. Zoletil 50 IM not 100% effective. "Top up with isoflurane gas," I advised.
3. Electrosurgical excision was in <1 bleeding.="bleeding." nbsp="nbsp" no="no" second.="second.">4. A 3rd-year student for 2013 studies from Melbourne Univ was on internsihp for 2 weeks and I have asked her to write about this electrosurgery in the dwarf hamster. The hamster with the ear growth was also operated using electrosurgery.
Website and updates will be done later at www.toapayohvets.com --- goto hamsters.
1215. Follow up on the epulis Golden Retriever - ticks
I reviewed this case of the 12-year-old Golden Retriever who came in as he was "panting" after eating and after exercise walking for the past 3 days. No such panting before that. What was the cause?
This dog was operated in July 2012 for a large epulis which was bleeding.
See case at: http://www.sinpets.com/F5/2012072gigantic_epulis_labrador_toapayohvets.htm
He had a "gingival biopsy" of the mass in 2009 by another vet. The report stated "fibromatous epulis of periodontal origin". It said that it is generally a benign entity in the dog and complete surgical excision isusualy difficult due to indistinct boundaries between the epulis and normal gingival tissue. That was in Dec 2009. However, the lump bled a lot and so the owner came to me and I advised surgery n July 2012. 2.5 years had passed. Gum tumours are best excised when they are small.
Taking a sample for tissue biopsy is part of the process to ascertain whether it is cancerous or not. This adds to the cost and so I usually do not advise it. Just excise the mass and send to the lab for checking of its cancerous nature or otherwise.
I checked the gums. They were OK and reddish pink.
"Has the dog been exposed to ticks recently?" I asked. The two gentleman owners had said that their dog never had ticks for many years but he had a lot of ticks just 2 weeks ago. "Every day, we pluck out the ticks," the owners said. "But now he is tick-free."
"You could have used a tick bath or dip," I said.
"Well, I bought a tablet from the internet and all the ticks died. There are various suppliers and prices vary."
It seems that this tablet worked well. The owner sms me the name: Nitenpyram. by Bob Martin. Owners nowadays do their research and experiment. They should check out the effects and side effects of the medication.
http://www.drsfostersmith.com/Rx_Info_Sheets/rx_nitenpyram.pdf has info on Nitenpyram. Its use to kill ticks is not known. It is effective to kill adult fleas only.
So what is the cause of the panting? The dog does not have heartworms nor severe heart disease. No fever. Could it be tick fever? The owners did not want a tick fever blood smear test. Nowadays, owners with research knowledge can be demanding. It is up to how the vet is able to communicate with such well informed owners. If the vet does not know how to communicate and if this dog comes down with tick fever later and dies, the owner will not blame himself as he had sought the vet's opinion. As at yesterday, there was no anaemia and no fever. So, it couldn't be tick fever. It is not as simple as that as tick fever could be at its first stage.
This dog was operated in July 2012 for a large epulis which was bleeding.
See case at: http://www.sinpets.com/F5/2012072gigantic_epulis_labrador_toapayohvets.htm
He had a "gingival biopsy" of the mass in 2009 by another vet. The report stated "fibromatous epulis of periodontal origin". It said that it is generally a benign entity in the dog and complete surgical excision isusualy difficult due to indistinct boundaries between the epulis and normal gingival tissue. That was in Dec 2009. However, the lump bled a lot and so the owner came to me and I advised surgery n July 2012. 2.5 years had passed. Gum tumours are best excised when they are small.
Taking a sample for tissue biopsy is part of the process to ascertain whether it is cancerous or not. This adds to the cost and so I usually do not advise it. Just excise the mass and send to the lab for checking of its cancerous nature or otherwise.
I checked the gums. They were OK and reddish pink.
"Has the dog been exposed to ticks recently?" I asked. The two gentleman owners had said that their dog never had ticks for many years but he had a lot of ticks just 2 weeks ago. "Every day, we pluck out the ticks," the owners said. "But now he is tick-free."
"You could have used a tick bath or dip," I said.
"Well, I bought a tablet from the internet and all the ticks died. There are various suppliers and prices vary."
It seems that this tablet worked well. The owner sms me the name: Nitenpyram. by Bob Martin. Owners nowadays do their research and experiment. They should check out the effects and side effects of the medication.
http://www.drsfostersmith.com/Rx_Info_Sheets/rx_nitenpyram.pdf has info on Nitenpyram. Its use to kill ticks is not known. It is effective to kill adult fleas only.
So what is the cause of the panting? The dog does not have heartworms nor severe heart disease. No fever. Could it be tick fever? The owners did not want a tick fever blood smear test. Nowadays, owners with research knowledge can be demanding. It is up to how the vet is able to communicate with such well informed owners. If the vet does not know how to communicate and if this dog comes down with tick fever later and dies, the owner will not blame himself as he had sought the vet's opinion. As at yesterday, there was no anaemia and no fever. So, it couldn't be tick fever. It is not as simple as that as tick fever could be at its first stage.
Sunday, December 9, 2012
1214. Follow-up. "Closed pyometra" case
Two days ago, this 11-year-old female Maltese was operated by Dr Daniel and me. This was a strange case. Total white cell count was very high in the blood test.. A swollen abdomen with a globular lump. I said it was a very full bladder on first palpation but Dr Daniel said the dog had peed all urine. An X-ray showed a big globular swelling and I was quite sure it was the bladder.
BLOOD TEST ON DEC 6, 2012
Serum urea 22 (4.2 to 6.3), creatinine 188 (89-177).
RBC 4.8 (5.5-8.5), Haemoglobin 9.9 (12-18).
Total WCC 62 (6-17), N=98%, L 1.7%, M, E, B.
Platelets 131 (200-500) was low suggestive of toxaemia
SURGERY ON DEC 7, 2012
The biggest bladder ever seen. Like 3/4 of a Thai mango. The dog had been given IV drip 12 hours ago to pep her up for surgery and increase her chances of survival. More than 15 cm long. I aspirated the urine with a sterile syringe from the apex of the bladder and sent for urine analysis.
Urine colour: Colourless.
Clarity: Slight turbid.
pH 5.0 (5-8).
SG 1.012 (1.005-1.030)>2250. RBC 90 (Possible haemolysis of RBC in urine).
Bacteria 2+. Crystals Nil.
"Urinary stones might not be radio-dense and so would not be seen in the X-rays," I said to Dr Daniel who was operating. "Flush out the bladder, irrigate it. Put a catheter into the bladder and pass it out through the urethra from the bladder." There was cystitis. Negative crystals in urine do not mean no urinary stones.
When Dr Daniel tried to pass the catheter out from the neck of the bladder, there was obstruction. "It is possible that there could be a urinary stone stuck inside the short urethra and not visible on the X-ray," I said. After 2 minutes, he managed to pass the catheter out of the urethra and the vulval lips. "There could be a urethral obstruction in the female dog as well." Most vets don't pass the urethral catheter via the vulval vestibule as they deem it difficult to do it, unlike in the dog.
"Check the neck of the bladder for tumours," I said. "Extend the incision of the skin caudally. There was a large reddish lump at the neck of the bladder on the outside. I took an image for the owner to see.
DISCUSSION WITH THE OWNERS
Today was the first time I met the father and two young adult daugthers.
"Did the dog have difficulty passing urine?" I asked.
"Yes," one daughter said. "She took a long time to pee and only a few drops of urine came out."
I reviewed the record on Dec 6 when the dog was admitted. "Urine sticky. Stools red and yellow past 2 weeks. Appetite decreased. Vomited once." Pyometra was suspected but the onset of heat was unknown.
BLOOD TEST ON DEC 6, 2012
Serum urea 22 (4.2 to 6.3), creatinine 188 (89-177).
RBC 4.8 (5.5-8.5), Haemoglobin 9.9 (12-18).
Total WCC 62 (6-17), N=98%, L 1.7%, M, E, B.
Platelets 131 (200-500) was low suggestive of toxaemia
SURGERY ON DEC 7, 2012
The biggest bladder ever seen. Like 3/4 of a Thai mango. The dog had been given IV drip 12 hours ago to pep her up for surgery and increase her chances of survival. More than 15 cm long. I aspirated the urine with a sterile syringe from the apex of the bladder and sent for urine analysis.
Urine colour: Colourless.
Clarity: Slight turbid.
pH 5.0 (5-8).
SG 1.012 (1.005-1.030)>2250. RBC 90 (Possible haemolysis of RBC in urine).
Bacteria 2+. Crystals Nil.
"Urinary stones might not be radio-dense and so would not be seen in the X-rays," I said to Dr Daniel who was operating. "Flush out the bladder, irrigate it. Put a catheter into the bladder and pass it out through the urethra from the bladder." There was cystitis. Negative crystals in urine do not mean no urinary stones.
When Dr Daniel tried to pass the catheter out from the neck of the bladder, there was obstruction. "It is possible that there could be a urinary stone stuck inside the short urethra and not visible on the X-ray," I said. After 2 minutes, he managed to pass the catheter out of the urethra and the vulval lips. "There could be a urethral obstruction in the female dog as well." Most vets don't pass the urethral catheter via the vulval vestibule as they deem it difficult to do it, unlike in the dog.
"Check the neck of the bladder for tumours," I said. "Extend the incision of the skin caudally. There was a large reddish lump at the neck of the bladder on the outside. I took an image for the owner to see.
DISCUSSION WITH THE OWNERS
Today was the first time I met the father and two young adult daugthers.
"Did the dog have difficulty passing urine?" I asked.
"Yes," one daughter said. "She took a long time to pee and only a few drops of urine came out."
I reviewed the record on Dec 6 when the dog was admitted. "Urine sticky. Stools red and yellow past 2 weeks. Appetite decreased. Vomited once." Pyometra was suspected but the onset of heat was unknown.
1213. Sunday Dec 9, 2012's interesting cases
Sunday Dec 9, 2012
I seldom have expatriates as clients and was surprised to encounter 3.
Case 1. Shedding Husky. Buinsessman, his wife and pre-teen son who loves tennis.
Husky, female, 1 year 4 months. Shedding hair for last 2 weeks. "Hair all over the house," mum would say. Yet I did not see any hair loss as the son combs the dog daily.
"Hair shedding is common in Huskies," I said. "Causes include hot weather, ticks, recent heat and after birth."
"Was the dog carrying a toy in her mouth and protecting it?" I checked there was no milk in the nipples nor were they enlarged.
"Yes, one month ago. She would not part with it and was very possessive."
However, the left ear was very itchy and the dog would move her head away whenever I tried to examine it. A wet dark exudate presented on the cotton tip. The right ear was also itchy. So the dog tried to relieve her itchiness by using her hind legs to scratch the flanks and causing hair loss.
The solution was to treat the ears with proper ear drops and to plan to breed the Husky on the next heat. The father wanted a pup from her just for one litter. So I advised properly timing and everybody was happy.
Case 2. "Debarking" cats.
"I have never heard of anyone asking to debark cats," I said to the Caucasian caller over the phone today at 3 pm. He said that the cat would make loud noises and this may wake up his baby, due to arrive in May 2013.
"Other than this habit of making loud noises that may wake up the baby at 3a.m, he is a sweet gentle cat. I don't want to send him to the SPCA or get rid of him. Is it possible to debark him?"
"At what times is your cat vocal?" I asked.
"Early morning and late at night."
"Just like a cock crowing at dawn?" I asked.
"Yes, like a rooster but he does it at night too. What do you propose? I have him neutered at another vet at 5 months of age. Now he is 11 months old. He has been doing that since he is a kitten."
"You are the first person to enquire about debarking cats."
"That is why they refer to debarking. It is meant for dogs," he said.
I advised boarding the cat for one month to change his behaviour or crate him and cover the crate with a big towel to give him security and changing his routine. Will this work? The expat thanked me and might let me know.
Case 3. Two macadema nuts in a dwarf hamster.The Caucasian man brought his plump hamster for a review 2 weeks after treatment from Dr Vanessa. He had been to other vets but the hamster still has complete hair loss and redness on the lower body and the legs, on the back spinal area and left ear area. This has been going on for some weeks. The lower skin and neck were not so red but hairs did not grow back.
I saw scales on the shoulder area and the Mr Min could easily pluck out the hairs for a microscopic examination for ringworm. A few hairs had ringworm but most were OK. Was it skin mites? Or management? The hamster had been eating various kinds of food and had to climb into a feed bowl which was rather sharp. "Change to a lower feed bowl with smooth edges," I advised also putting the hamster on paper towels for a month."
This could be a case of management as the hamster was free to roam in the room. There are many causes and it will take time to know. In any case, I noted that the skin below the left ear was hairless and the left cheek pouch was hard. "There could be an impacted pouch," I said. "I need to give it a little bit of anaesthesia gas and check the pouch."
"Will it be safe for my hamster?" the man had said that his hamster had been passing blood for 5 days earlier.
"Yes, it will be safe as it is gas anaesthesia and takes a few seconds."
The left cheek pouch was impacted with two large cream-coloured macadema nuts and the hamster was trying to dislodge them by scratching till the skin below the left ear was bald.
"My wife is a pastry chef," the gentleman was surprised to see two big nuts of around 6 mm in length.
"No more macadema nuts or any other food other than a good quality hamster food," I advised bathing the hamster with the anti-fungal shampoo, clipping the hair, using paper towel as bedding for 4 weeks and reviewing after 4 weeks.
So, this Sunday was quite interesting with 3 different types of animals posing challenging problems for me.
I seldom have expatriates as clients and was surprised to encounter 3.
Case 1. Shedding Husky. Buinsessman, his wife and pre-teen son who loves tennis.
Husky, female, 1 year 4 months. Shedding hair for last 2 weeks. "Hair all over the house," mum would say. Yet I did not see any hair loss as the son combs the dog daily.
"Hair shedding is common in Huskies," I said. "Causes include hot weather, ticks, recent heat and after birth."
"Was the dog carrying a toy in her mouth and protecting it?" I checked there was no milk in the nipples nor were they enlarged.
"Yes, one month ago. She would not part with it and was very possessive."
However, the left ear was very itchy and the dog would move her head away whenever I tried to examine it. A wet dark exudate presented on the cotton tip. The right ear was also itchy. So the dog tried to relieve her itchiness by using her hind legs to scratch the flanks and causing hair loss.
The solution was to treat the ears with proper ear drops and to plan to breed the Husky on the next heat. The father wanted a pup from her just for one litter. So I advised properly timing and everybody was happy.
Case 2. "Debarking" cats.
"I have never heard of anyone asking to debark cats," I said to the Caucasian caller over the phone today at 3 pm. He said that the cat would make loud noises and this may wake up his baby, due to arrive in May 2013.
"Other than this habit of making loud noises that may wake up the baby at 3a.m, he is a sweet gentle cat. I don't want to send him to the SPCA or get rid of him. Is it possible to debark him?"
"At what times is your cat vocal?" I asked.
"Early morning and late at night."
"Just like a cock crowing at dawn?" I asked.
"Yes, like a rooster but he does it at night too. What do you propose? I have him neutered at another vet at 5 months of age. Now he is 11 months old. He has been doing that since he is a kitten."
"You are the first person to enquire about debarking cats."
"That is why they refer to debarking. It is meant for dogs," he said.
I advised boarding the cat for one month to change his behaviour or crate him and cover the crate with a big towel to give him security and changing his routine. Will this work? The expat thanked me and might let me know.
Case 3. Two macadema nuts in a dwarf hamster.The Caucasian man brought his plump hamster for a review 2 weeks after treatment from Dr Vanessa. He had been to other vets but the hamster still has complete hair loss and redness on the lower body and the legs, on the back spinal area and left ear area. This has been going on for some weeks. The lower skin and neck were not so red but hairs did not grow back.
I saw scales on the shoulder area and the Mr Min could easily pluck out the hairs for a microscopic examination for ringworm. A few hairs had ringworm but most were OK. Was it skin mites? Or management? The hamster had been eating various kinds of food and had to climb into a feed bowl which was rather sharp. "Change to a lower feed bowl with smooth edges," I advised also putting the hamster on paper towels for a month."
This could be a case of management as the hamster was free to roam in the room. There are many causes and it will take time to know. In any case, I noted that the skin below the left ear was hairless and the left cheek pouch was hard. "There could be an impacted pouch," I said. "I need to give it a little bit of anaesthesia gas and check the pouch."
"Will it be safe for my hamster?" the man had said that his hamster had been passing blood for 5 days earlier.
"Yes, it will be safe as it is gas anaesthesia and takes a few seconds."
The left cheek pouch was impacted with two large cream-coloured macadema nuts and the hamster was trying to dislodge them by scratching till the skin below the left ear was bald.
"My wife is a pastry chef," the gentleman was surprised to see two big nuts of around 6 mm in length.
"No more macadema nuts or any other food other than a good quality hamster food," I advised bathing the hamster with the anti-fungal shampoo, clipping the hair, using paper towel as bedding for 4 weeks and reviewing after 4 weeks.
So, this Sunday was quite interesting with 3 different types of animals posing challenging problems for me.
1212. "Tiny" ear tumour on dwarf hamster email query
On Sun, Dec 9, 2012 at 8:38 AM, Z..@gmail.com> wrote:
EMAIL REPLY SUNDAY DEC 9, 2012 9.28 AM FROM TOA PAYOH VETS
I am Dr Sing from Toa Payoh Vets. Thank you for your email. The "tiny" ear tumour needs to be removed by surgery and under anaesthesia. The ear canals need to be examined for other growths.
The approximate cost is $150-$200 for consultation, anaethesia, surgery (+/- stitching) and medication. Appointment is by phone 6254-3326. Bring hamster at 9.30 am and it goes home by 4 pm usually. Best wishes.
Dear Sir/Mdm,
I have just discovered a tiny growth on the ear of my hamster. Attached are the pictures for your reference.
I would like to know if there is any treatment for my hamster and the cost of it.
If so, pls advise on an appointment date and time. Thank you.
Regards,
Z
EMAIL REPLY SUNDAY DEC 9, 2012 9.28 AM FROM TOA PAYOH VETS
I am Dr Sing from Toa Payoh Vets. Thank you for your email. The "tiny" ear tumour needs to be removed by surgery and under anaesthesia. The ear canals need to be examined for other growths.
The approximate cost is $150-$200 for consultation, anaethesia, surgery (+/- stitching) and medication. Appointment is by phone 6254-3326. Bring hamster at 9.30 am and it goes home by 4 pm usually. Best wishes.
Friday, December 7, 2012
1211. Straits Times Classified to sell mini-maltese
A silver Mercedes parked outside my Surgery. A fair lady in her 40s, wearing sparkling diamond ear rings and low cut came to my surgery with 2 mini-Maltese pups and their parents for vaccination and her domestic worker. She was referred to me by Boon who I believe to be a dog breeder.
I could just vaccinate and she would rush home but I am concerned she is keeping too many puppies.
"The mini-maltese pups are getting bigger," I said. "Are you selling them?"
"I sold one at $1,500," she said. "But my son is in the US studying and does not help me to advertise in the internet."
"As they are young, it is best to sell them to a pet shop if you don't want to do it yourself," I said.
"Pet shops offer me $400/pup," she said.
I advised her to advertise 3 lines in the Straits Times, Classified 74, Pets/Pets Care, preferably on a Saturday.
2 Mini-Maltese pups for sale. $1.2-$1.6K. Vaccinated. Tel: XXX
This classified cost around $39.00 and should get much response.
"You may get con-men who takes your pups outside the house and run away," I warned her.
"I will ask my two maids to be careful," she said. "I don't accept deposits."
"Not many people carry a thousand dollars. You can keep the mum till the buyer returns with the balance of payment."
Grown up sons overseas nowadays are too busy to help mum to advertise the puppies for sale. Vets must be proactive to help clients who have excess pups. Otherwise they end up with too many as the laws permit 3 dogs/private residence and 1/public residence.
1210. Follow up: British Bulldog - stone analysis is struvite stone
Dr Daniel made a follow up phone call to the owner yesterday Dec 7, 2012.
"Lots of bleeding from the operation area," the lady owner said. So, she brought the dog over to the surgery at 7.30 pm. Dr Daniel took out the plaster. I noted there was no bleeding. The dissolvable stitches (simple interrupted) were in place. Dr Daniel took out the stitches.
"You should be feeding the Bulldog 1 and 1/2 cans of S/D per day based on her weight instead of 2/3 cans". The dog is now trim and on the thin side.
"I feed one can only," she said. "I note that the Bulldog no longer pants and is more energetic. So, I feed 1 can so that she would not put on weight!"
Owner compliance is much difficult. At least there is no blood in the urine so far. The stone analysis show struvite stone. A peculiar spiky one.
The dog had dry dog food when she was around one years old but the owner claimed that the dog was on home-cooked food from year 1 to 4 as a vet had told her that the skin disease would go away when the dog is fed home-cooked food. Yet such a large stone of 1.5 cm x 1.5 cm x 1.5 cm could not be formed overnight. It would take months to form.
Webpage:
http://www.sinpets.com/F5/20121206_bulldog_urinary_stones_toapayohvets.htm
"Lots of bleeding from the operation area," the lady owner said. So, she brought the dog over to the surgery at 7.30 pm. Dr Daniel took out the plaster. I noted there was no bleeding. The dissolvable stitches (simple interrupted) were in place. Dr Daniel took out the stitches.
"You should be feeding the Bulldog 1 and 1/2 cans of S/D per day based on her weight instead of 2/3 cans". The dog is now trim and on the thin side.
"I feed one can only," she said. "I note that the Bulldog no longer pants and is more energetic. So, I feed 1 can so that she would not put on weight!"
Owner compliance is much difficult. At least there is no blood in the urine so far. The stone analysis show struvite stone. A peculiar spiky one.
Webpage:
http://www.sinpets.com/F5/20121206_bulldog_urinary_stones_toapayohvets.htm
1209. Hamster from Malaysia email query
On Fri, Nov 30, 2012 at 5:01 PM, F@hotmail.com> wrote:
------------------------------------------
Dec 7, 2012 REPLY FROM DR SING
Pl accept my apologies for the late reply.
Skin diseases in hamsters are due to many causes including trauma, mites, fungal, bacterial, allergies and poor management. I am sorry I can't help you via the internet correspondence.
Hello Dr Sing Kong Yuen,
I'm from malaysia and i came across your site everytime i need to search information whenever i suspect my robo hamster are not feeling well which is not a good things. Past few weeks my 2 years old robo hamster been sctraching more than usual & i notice some bald patch. I took him to vet & the vet told me that my robo hamster are having demodex mites if i'm not mistaken. I couldn't find much information about this mites. If you could kind enough to explain more about this mites to me as It's kinda hard to find vet that take small animals as hamster at malaysia here.
The vet giving us some oral medication to be feed to our hamster with syringe twice per week. Today was my hamster 2nd medicine after last 3 days we have feed him with his 1st medicine. I have not seen any improvement on our hamster. Am i over worried dr. sing? When i'll see improvement on my hamster after the medicine? Is this demodex mites dangerous? is it serious? Can it be cure? He is my 1st hamster & it's very sad to see him suffer. It's worse than having myself to sick
Thank you.
Regards,
F
------------------------------------------
Dec 7, 2012 REPLY FROM DR SING
Pl accept my apologies for the late reply.
Skin diseases in hamsters are due to many causes including trauma, mites, fungal, bacterial, allergies and poor management. I am sorry I can't help you via the internet correspondence.
Thursday, December 6, 2012
1208. Calcium oxalate stones in a 10-year-old Jack Russell
"U/D will not dissolve the calcium oxalate stones," I said. "Unlike S/D diet which can dissolve small struvite stones."
Not every dog with calcium oxalate or other urinary stones need surgical removal. However, in this case, blood is still being passed with the urine and there is urethral obstruction of urine flow. Since U/D diet does not dissolve the calcium oxalate stones, but just prevent formation of more stones, it is best to remove such stones in this old dog and be careful.
1207. 12-year-old cat with two ingrown toe nails
Dec 6, 2012
Many phone queries cannot be answered by the receptionist as they are technical. Should the vet answer phone calls? That sounds a bit inappropriate for the top dog in a veterinary practice. However, answering phone calls should not be a shameful task as many prospects who receive satisfactory answers to their technical queries will turn up.
Sometimes, I think they are sophisticated pet owners who want to test the veterinary practice staff before they part with their hard-earned money. An old experienced vet nurse who have worked in practice for more than 10 years should be able to handle such queries but they are now as extinct as the dodo.
Two days ago, I had a phone call from a lady who asked if I declaw cats.
"Not as a routine," I said. "Only in exceptional circumstances where there is a need to do it. It is considered cruelty."
"Do you declaw the back legs as well?" she asked.
"Not necessary to do so," I said. "The cat uses his front legs to claw sofas, curtains and furniture, not the back legs."
"Well, I had a cat who uses her back leg to scratch my parquet floors!"
"Life is full of surprises and behavioural changes," I said. "This is the first time I hear a cat using the hind legs to scratch."
She thanked me and I learnt something new about cats.
Yesterday, the tanned lady in her late 30s came with her black and white cat. Her cat had two ingrown toe nails on the right fore paw. She work overseas and her maid did not dare to clip the nails till the dew claw and the 2nd digit claw curved into the flesh. The nails had exploded in width and the cat was not happy if you touch it. She was still a gentle female spayed cat though.
"A vet told me to just clip the nails and if the nails over-grow, to clip them again."
"That is the standard treatment," I said.
She wanted a permanent solution as she worked overseas and had no time to get the cat to the groomer or vet to trim off the ends of the overgrown nails. Time is short for city living folks and it is short for me too. So, I understood her situation but she had to decide whether to get the cat declawed.
"Only the two claws need to be removed," I said. I did not warn her that her cat might die under the sedation as this was a very short surgery and no cats ever die when the anaesthesia and surgery is as short as less than 5 minutes. For legal reasons, the vet has to inform the owner of the risks of anaesthesia and death on the operating table and asked her to sign the "informed consent" form.
I did not think this was necessary in this case.
"Remove the Phalanx one at the P1 and P2 joint," I said to Dr Daniel. This surgery should be a piece of cake for him unlike cystotomy or perineal hernial repair. He operated and on the 2nd day, the lady came at 5 pm.
I was present as Dr Daniel had gone to the SAFRA gym. "Check the left front paw," I said to the sun-tanned lady with shoulder strapped blue dress. She had purchased a large luxurious towel bought from IKEA to cover the carrier.
"I thought you use the towel to wrap the cat," I said.
"No," she laughed. "Once this cat peed through the door of the carrier onto the car seat. So, now I wrap the carrier with this big towel to prevent such incidents!"
A red car was waiting outside my Surgery. After she settled her bills with her credit card, she wrapped the carrier with the towel and went to the car. An elderly man came out and opened the door. "You must be the father," I guessed as the age difference would be twice. "Yes," he nodded his head. I said goodbye to the happy lady.
This old cat now has no kidney disorders as she had a blood test but the lady would continue feeding her the kidney diet. "The eosinophils at 9.6% is high. The platelets at 194 (300-800) are low."
"Why?" she asked.
"It is possible that the cat had ingested some poison or some application had been put on the ingrown toe nails."
This was a mystery as she said she did not do it.
The backside hair loss on both sides would be less of a mystery. I massaged the anal sacs and 1 ml of dark chocolate oil shot out. "This would be impacted anal sacculitis," I said. "The hair should grow back after some time."
Many phone queries cannot be answered by the receptionist as they are technical. Should the vet answer phone calls? That sounds a bit inappropriate for the top dog in a veterinary practice. However, answering phone calls should not be a shameful task as many prospects who receive satisfactory answers to their technical queries will turn up.
Sometimes, I think they are sophisticated pet owners who want to test the veterinary practice staff before they part with their hard-earned money. An old experienced vet nurse who have worked in practice for more than 10 years should be able to handle such queries but they are now as extinct as the dodo.
Two days ago, I had a phone call from a lady who asked if I declaw cats.
"Not as a routine," I said. "Only in exceptional circumstances where there is a need to do it. It is considered cruelty."
"Do you declaw the back legs as well?" she asked.
"Not necessary to do so," I said. "The cat uses his front legs to claw sofas, curtains and furniture, not the back legs."
"Well, I had a cat who uses her back leg to scratch my parquet floors!"
"Life is full of surprises and behavioural changes," I said. "This is the first time I hear a cat using the hind legs to scratch."
She thanked me and I learnt something new about cats.
Yesterday, the tanned lady in her late 30s came with her black and white cat. Her cat had two ingrown toe nails on the right fore paw. She work overseas and her maid did not dare to clip the nails till the dew claw and the 2nd digit claw curved into the flesh. The nails had exploded in width and the cat was not happy if you touch it. She was still a gentle female spayed cat though.
"A vet told me to just clip the nails and if the nails over-grow, to clip them again."
"That is the standard treatment," I said.
She wanted a permanent solution as she worked overseas and had no time to get the cat to the groomer or vet to trim off the ends of the overgrown nails. Time is short for city living folks and it is short for me too. So, I understood her situation but she had to decide whether to get the cat declawed.
"Only the two claws need to be removed," I said. I did not warn her that her cat might die under the sedation as this was a very short surgery and no cats ever die when the anaesthesia and surgery is as short as less than 5 minutes. For legal reasons, the vet has to inform the owner of the risks of anaesthesia and death on the operating table and asked her to sign the "informed consent" form.
I did not think this was necessary in this case.
"Remove the Phalanx one at the P1 and P2 joint," I said to Dr Daniel. This surgery should be a piece of cake for him unlike cystotomy or perineal hernial repair. He operated and on the 2nd day, the lady came at 5 pm.
I was present as Dr Daniel had gone to the SAFRA gym. "Check the left front paw," I said to the sun-tanned lady with shoulder strapped blue dress. She had purchased a large luxurious towel bought from IKEA to cover the carrier.
"I thought you use the towel to wrap the cat," I said.
"No," she laughed. "Once this cat peed through the door of the carrier onto the car seat. So, now I wrap the carrier with this big towel to prevent such incidents!"
A red car was waiting outside my Surgery. After she settled her bills with her credit card, she wrapped the carrier with the towel and went to the car. An elderly man came out and opened the door. "You must be the father," I guessed as the age difference would be twice. "Yes," he nodded his head. I said goodbye to the happy lady.
This old cat now has no kidney disorders as she had a blood test but the lady would continue feeding her the kidney diet. "The eosinophils at 9.6% is high. The platelets at 194 (300-800) are low."
"Why?" she asked.
"It is possible that the cat had ingested some poison or some application had been put on the ingrown toe nails."
This was a mystery as she said she did not do it.
The backside hair loss on both sides would be less of a mystery. I massaged the anal sacs and 1 ml of dark chocolate oil shot out. "This would be impacted anal sacculitis," I said. "The hair should grow back after some time."
1206. Closed pyometra in an old Shih Tzu X
Dec 6, 2012
Ideally, it is best to use evidence-based medicine to get a diagnosis of closed pyometra. X-rays and blood tests are what the vet professors teach the new graduates.
However, in real life, there are clients who can't afford the tests. In this case, I usually get a good history and abdominal palpation of a big swollen uterus and operate to remove the uterus. There is always a possibility of no pyometra but a swollen bladder or an abdominal mass but economics prohibit more exploratory tests.
"It is how you present your case," I said to Dr Daniel. "If the owner has budget constraints, two X-rays add to the vet costs. There is a big orange-sized swelling in the abdomen. It could be the bladder but you said Mr Min had seen much urine being passed. Therefore, this globular swelling could be the uterus distended with pus."
The owner did not know when the last heat occurred. However there was vomiting yesterday and a complaint of sticky matter in the "urine." The dog was not eating much for the last 10 days. These clues point to pyometra. X-rays and blood tests will confirm.
The owner decided on X-rays.
There is closed pyometra, according to the X-rays. The uterus had swollen so much that the intestines were displaced forwards.
"Don't operate immediately," I said. "Give the IV drip and antibiotics 24 hours and operate after that. This ensures a better chance of survival, in my experience."
The owner will discuss further at around 7pm. There is no alternative but surgery to cure this dog. However, there is financial hardship for some owners and the newly graduate vet must the heartlander economics and provide the least cost surgery.
---------------------------------------------
Friday. Dec 7, 2012. The dog is better after IV drips yesterday but the rectal temp is below normal at 37.7 C.
The owner agreed to a blood test.
1. Kidney disorders. Urea 22 (4.2-6.3). Creatinine 188 (89-177).
2. Total WCC 62 (6-17) with N=98%. L=1.7%, M 0.3%. E & B =0%
3. Platelets 191 (200-500).
4. Haemoglobin 9.9 (12-18)
5. Red cell count 4.8 (5.5-8.5)
Surgery is necessary today but the risks are high as the dog has septicaemia and may die on the op table.
Ideally, it is best to use evidence-based medicine to get a diagnosis of closed pyometra. X-rays and blood tests are what the vet professors teach the new graduates.
However, in real life, there are clients who can't afford the tests. In this case, I usually get a good history and abdominal palpation of a big swollen uterus and operate to remove the uterus. There is always a possibility of no pyometra but a swollen bladder or an abdominal mass but economics prohibit more exploratory tests.
"It is how you present your case," I said to Dr Daniel. "If the owner has budget constraints, two X-rays add to the vet costs. There is a big orange-sized swelling in the abdomen. It could be the bladder but you said Mr Min had seen much urine being passed. Therefore, this globular swelling could be the uterus distended with pus."
The owner did not know when the last heat occurred. However there was vomiting yesterday and a complaint of sticky matter in the "urine." The dog was not eating much for the last 10 days. These clues point to pyometra. X-rays and blood tests will confirm.
The owner decided on X-rays.
There is closed pyometra, according to the X-rays. The uterus had swollen so much that the intestines were displaced forwards.
"Don't operate immediately," I said. "Give the IV drip and antibiotics 24 hours and operate after that. This ensures a better chance of survival, in my experience."
The owner will discuss further at around 7pm. There is no alternative but surgery to cure this dog. However, there is financial hardship for some owners and the newly graduate vet must the heartlander economics and provide the least cost surgery.
---------------------------------------------
Friday. Dec 7, 2012. The dog is better after IV drips yesterday but the rectal temp is below normal at 37.7 C.
The owner agreed to a blood test.
1. Kidney disorders. Urea 22 (4.2-6.3). Creatinine 188 (89-177).
2. Total WCC 62 (6-17) with N=98%. L=1.7%, M 0.3%. E & B =0%
3. Platelets 191 (200-500).
4. Haemoglobin 9.9 (12-18)
5. Red cell count 4.8 (5.5-8.5)
Surgery is necessary today but the risks are high as the dog has septicaemia and may die on the op table.
Wednesday, December 5, 2012
1205. Mynamar stories - An unhappy girl
On one afternoon in Dec 2012, I was at the office of Khin Khin Employment Agency. A thin fair lady in her late 20s came into the office to ask her to find an employer after working 6 months with the present employer who had told her that her services would end on Dec 15, 2012.
"Why do you want to spend more money in agency fees when you have a job now. You just put back $500 into your POSB account, apologise to your employer and complete your S pass contract," Khin Khin said loudly. "You should not have taken out the money as your boss had told you not to."
I was surprised that she could be sacked just for this $500. "Can you find the $500 to put back into the account?" I asked. "How much agency fee did you pay to get this job?" She said she had the money and had paid $4,500 agency fee.
"How much are you getting?" I asked. She said she got a good pay but she could not tolerate being scolded by her boss and colleagues.
"How many days off per month do you get?" I asked.
"4 days off," she said.
"So you have a good working condition," Khin Khin and I said. But there must be more to it than the $500 disobedience. I tried to help her by asking for her boss phone number since Khin Khin might not have the patience or ability to salvage this job loss situation with a Singapore employer.
The girl did not have the phone number. So I surfed the internet, got the company name and phoned the mobile number displayed. It was her boss. "Who are you?" she asked me. "I am Dr Sing from Toa Payoh Vets," I said. "I am just trying to help your employee who said she would put back the $500 into the savings account and I hope she would get her job back."
"It is not the $500 which she already withdrew since the first month of work. Her agent had talked to her and I had waited for 6 months but her work attitude was bad. She swept the dirt under the table and this is 'pantung' (bad luck) to a Peranakan. She also smashed the curry puffs. I have given her Dec 15 as her last day and she has one month to look for an employer."
So this was an unhappy girl who had her first job in Singapore. A job so difficult to get nowadays as the Government clamped down on approvals even for employers who have the quota. Just a rejection letter for most employers. And there are so many young Myanmar ladies who are looking for a job in Singapore to support their families and to improve their standard of living. Yet, this unhappy girl showed her tantrums and misconduct.
She nodded her head when I told her that she had swept the dirt under the table and smashed the curry puffs in anger. "You must be from a rich Myanmar family," I said. Spending $4,500 on agency fees and more expenses just to get a job in Singapore cannot be affordable to the average Myanmar girl. "No, I am not", she said. A graduate in Myanmar with a good command of English and good looks may earn US$300-500 per month in a big company. It is just not easy to get a job in Yangon for higher pay. There are 60 million people in Myanmar and competition for jobs must be much more intense unlike the young Singaporean counterparts who can pick and choose their employer.
Poor work attitude afflicts many from the younger generation in their first job when the employment vacancies are high. As for this unhappy girl, I don't see any hope of her getting another job as there will be newer girls with no "leaving the Singapore employer before the end of contract - a red flag for employers" arriving in Khin Khin's office to look for jobs. Many of them can converse in good English and Mandarin, esp. from the Kachin State which is near to China.
P.S. According to one Myanmar lady in her 50s, she said that the Myanmar government stopped the teaching of English in primary schools in 1962. Those who studied English were ridiculed. So, the new generation of Myanmar nationals can't speak English proficiently.
"Why do you want to spend more money in agency fees when you have a job now. You just put back $500 into your POSB account, apologise to your employer and complete your S pass contract," Khin Khin said loudly. "You should not have taken out the money as your boss had told you not to."
I was surprised that she could be sacked just for this $500. "Can you find the $500 to put back into the account?" I asked. "How much agency fee did you pay to get this job?" She said she had the money and had paid $4,500 agency fee.
"How much are you getting?" I asked. She said she got a good pay but she could not tolerate being scolded by her boss and colleagues.
"How many days off per month do you get?" I asked.
"4 days off," she said.
"So you have a good working condition," Khin Khin and I said. But there must be more to it than the $500 disobedience. I tried to help her by asking for her boss phone number since Khin Khin might not have the patience or ability to salvage this job loss situation with a Singapore employer.
The girl did not have the phone number. So I surfed the internet, got the company name and phoned the mobile number displayed. It was her boss. "Who are you?" she asked me. "I am Dr Sing from Toa Payoh Vets," I said. "I am just trying to help your employee who said she would put back the $500 into the savings account and I hope she would get her job back."
"It is not the $500 which she already withdrew since the first month of work. Her agent had talked to her and I had waited for 6 months but her work attitude was bad. She swept the dirt under the table and this is 'pantung' (bad luck) to a Peranakan. She also smashed the curry puffs. I have given her Dec 15 as her last day and she has one month to look for an employer."
So this was an unhappy girl who had her first job in Singapore. A job so difficult to get nowadays as the Government clamped down on approvals even for employers who have the quota. Just a rejection letter for most employers. And there are so many young Myanmar ladies who are looking for a job in Singapore to support their families and to improve their standard of living. Yet, this unhappy girl showed her tantrums and misconduct.
She nodded her head when I told her that she had swept the dirt under the table and smashed the curry puffs in anger. "You must be from a rich Myanmar family," I said. Spending $4,500 on agency fees and more expenses just to get a job in Singapore cannot be affordable to the average Myanmar girl. "No, I am not", she said. A graduate in Myanmar with a good command of English and good looks may earn US$300-500 per month in a big company. It is just not easy to get a job in Yangon for higher pay. There are 60 million people in Myanmar and competition for jobs must be much more intense unlike the young Singaporean counterparts who can pick and choose their employer.
Poor work attitude afflicts many from the younger generation in their first job when the employment vacancies are high. As for this unhappy girl, I don't see any hope of her getting another job as there will be newer girls with no "leaving the Singapore employer before the end of contract - a red flag for employers" arriving in Khin Khin's office to look for jobs. Many of them can converse in good English and Mandarin, esp. from the Kachin State which is near to China.
P.S. According to one Myanmar lady in her 50s, she said that the Myanmar government stopped the teaching of English in primary schools in 1962. Those who studied English were ridiculed. So, the new generation of Myanmar nationals can't speak English proficiently.
1204. Integrity, meticulousness and bungling
Some young men are accident prone. I know of one young man. Whenever he plays football, he ends up with broken toe nails and lameness most of the time. I was surprised to encounter another young man in a similar predicament.This young man wanted to study vet medicine and he interned at my place. He got As for O level and is in a top Junior College and so he should be an intelligent young man.
Yet some forces affect his work as an intern.
One day, I asked him to pull out the plastic tab of the IV drip bottle as part of his hands on work. It is like pulling the metal tab of a can of Coke. I had already said he is a bungling person. He pulled the ring. The ring came off but the circular plastic cover still covers the IV drip bottle. It is like pulling out the ring of the Coke can but you can't drink because the circular piece didn't come off.
On another occasion, he showed me a video production. I encouraged interns to do it. "How come you showed the owner going away from Toa Payoh Vets when he is supposed to enter the Surgery to consult the vet?". He said: "Nobody will know. It is done in movies."
"Integrity of a production or any work process is very important," i said. "You think viewers are stupid but many will point this out. I don't want this Toa Payoh Vets video to be a multi-media class-room case study of the lack of integrity in production. In the National Service, we call bungling person cocked up." The young man laughed. Somehow fate seemed to be against him.
So he changed the scene. The video now showed the owner walking the dog into the Surgery to consult the vet. Great. "But how come the owner coming to see the vet wears a blue T-shirt and yet in the consultation room, he wears a yellow shirt?" There is a need to be meticulous in a person's work esp. for a top school student.
After producing the video, he asked me to view it. I could see that the wording "subtitle/text" appeared again."Something wrong with the software," he said to me.
In the end, no video was produced. A lot of time was spent by me too.
Yet some forces affect his work as an intern.
One day, I asked him to pull out the plastic tab of the IV drip bottle as part of his hands on work. It is like pulling the metal tab of a can of Coke. I had already said he is a bungling person. He pulled the ring. The ring came off but the circular plastic cover still covers the IV drip bottle. It is like pulling out the ring of the Coke can but you can't drink because the circular piece didn't come off.
On another occasion, he showed me a video production. I encouraged interns to do it. "How come you showed the owner going away from Toa Payoh Vets when he is supposed to enter the Surgery to consult the vet?". He said: "Nobody will know. It is done in movies."
"Integrity of a production or any work process is very important," i said. "You think viewers are stupid but many will point this out. I don't want this Toa Payoh Vets video to be a multi-media class-room case study of the lack of integrity in production. In the National Service, we call bungling person cocked up." The young man laughed. Somehow fate seemed to be against him.
So he changed the scene. The video now showed the owner walking the dog into the Surgery to consult the vet. Great. "But how come the owner coming to see the vet wears a blue T-shirt and yet in the consultation room, he wears a yellow shirt?" There is a need to be meticulous in a person's work esp. for a top school student.
After producing the video, he asked me to view it. I could see that the wording "subtitle/text" appeared again."Something wrong with the software," he said to me.
In the end, no video was produced. A lot of time was spent by me too.
Follow up: Golf ball lump in a Golden Retriever's face
Dec 4, 2012 9.23 am
I reviewed the surgical case done on Oct 14, 2012. Not possible to talk to the busy owner for long but he said dog is OK and would check if the nylon stitches have been removed.
Golden Retriever, M, 9 years, 27kg
Blood test - Total WCC = 5.2 (6-17) which is low. N=63% OK, L=22%, M 8%, E6%, B1%. Surprisingly in June 4, 2012, the Total WCC = 3.3 which was lower. N=55%, L 28%, M 11% E4%, B2%. Platelets 110 (200-500). The dog came in for vaccination and health check and there was no complaint of ill health. This dog is very selective in eating.
PRE-OP
24 hours before surgery, IV drip and antibiotics
ANAESTHESIA
Not a fit candidate for anaesthesia as Total WCC is low and the dog is old and thin. Short surgery, the better chance of survival.
SURGERY
Electro-surgery controls bleeding better. Still time between first skin incision and last stitch took 57 minutes and isoflurane gas time = 85 minutes. Xylazine 1.3 ml + Ketamine 0.3 ml IV provides ineffective sedation. Needed isoflurane gas mask top up. Nylon 2/0 x2 packets. PDS 2/0 x 1 packet used.
HISTOPATHOLOGY. Granulation tissue either due to ulcer or wall of abscess. Had eaten chicken bones which could have pierced the cheek muscles.
CONCLUSION
Blood test is useful in health screening pre-op. Still, there is need to be speedy, accurate and completeness in surgery.
As at Dec 5, 2012, owner said dog is OK.
I reviewed the surgical case done on Oct 14, 2012. Not possible to talk to the busy owner for long but he said dog is OK and would check if the nylon stitches have been removed.
Golden Retriever, M, 9 years, 27kg
Blood test - Total WCC = 5.2 (6-17) which is low. N=63% OK, L=22%, M 8%, E6%, B1%. Surprisingly in June 4, 2012, the Total WCC = 3.3 which was lower. N=55%, L 28%, M 11% E4%, B2%. Platelets 110 (200-500). The dog came in for vaccination and health check and there was no complaint of ill health. This dog is very selective in eating.
PRE-OP
24 hours before surgery, IV drip and antibiotics
ANAESTHESIA
Not a fit candidate for anaesthesia as Total WCC is low and the dog is old and thin. Short surgery, the better chance of survival.
SURGERY
Electro-surgery controls bleeding better. Still time between first skin incision and last stitch took 57 minutes and isoflurane gas time = 85 minutes. Xylazine 1.3 ml + Ketamine 0.3 ml IV provides ineffective sedation. Needed isoflurane gas mask top up. Nylon 2/0 x2 packets. PDS 2/0 x 1 packet used.
HISTOPATHOLOGY. Granulation tissue either due to ulcer or wall of abscess. Had eaten chicken bones which could have pierced the cheek muscles.
CONCLUSION
Blood test is useful in health screening pre-op. Still, there is need to be speedy, accurate and completeness in surgery.
As at Dec 5, 2012, owner said dog is OK.
Tuesday, December 4, 2012
1202. Compliance issues in bladder stone prevention in a British Bulldog
Dec 4, 2012. I phoned the owner of the British bulldog, female, 4 years today as part of follow-up.
An interesting multi-lobed large globular bladder stone was removed by Dr Daniel on Nov 26, 2012 and the stone is being analysed.
"My dog is OK but now passes stools every 2 days, as if she is constipated," the owner said. The dog used to eat like a horse.
"How many cans of S/D do you feed/day?" I asked as this 19 kg dog should be eating 1 and 1/2 to 1 and 3/4 cans per day.
"I feed 2/3 cans/day to prevent her from being fat."
"Do you feed dog treats, bread or other food?" I asked.
"Some vegetables and fruits, but only occasionally," she said.
COMPLIANCE ISSUESOwners don't comply with strictly feeding on prescription diet. They will give some treats, bread and fruits after a while.
REVIEWS FOR URINARY TRACT INFECTIONS
Owners don't do that.
1. To prevent struvites, urinary pH = 6.2 to 6.42. To prevent calcium oxalates, urinary pH = 7.1 to 7.73-weekly urine analysis is recommended but no Singapore owners do that. Breeds like Schnauzers and Shih Tzus have a tendency to get urinary stones and reviews of UTI will have prevented costly surgeries.
STRUVITES. Use C/D after stone removal. S/D is to dissolve the stones.
CALCIUM OXALATE. Use U/D to prevent more calcium oxalate stone formation. U/D does not dissolve the stones.
Check for urinary pH
CASE STUDY OF THE BRITISH BULLDOG
Nov 19, 2012. Blood in the urine for past 2-3 days. Urine analysis and X-rays (bladder stone).
Nov 26, 2012. Cystostomy to remove the stone. Bladder wall thickened. Dr Daniel put one appositional continuous suture on submucosal layer and one inverting suture. I advised an additional layer of inverting suture as that would be what I would do. A urinary catheter could be used via urethra to pump saline into the bladder to check whether there is leakage but for 3 layers, I know that the closure is secure.
URINE ANALYSIS 2 TIMES
Nov 19, 2012. pH 8.0, SG 1.020, Pn 2+, Blood 4+, WBC 30, RBC 720, Bacteria Nil, Crystals Nil (history of haematuria for past 3 days only).
Nov 26, 2012. pH 8.0, SG 1.019, Pn 3+, Blood 4+, WBC >2250, RBC >2250, Bacteria 3+, Crystals triple phosphate occasional (history of haematuria for past 10 days). The dog was on trimax and medazole oral for 10 days and baytril injection. S/D X6 cans were fed.
Antibiotic sensistivity test not done.
POST OP
Stone analysis pending.
Oral Baytril 2 days, trimax bid x 10 days
S/D given but owner fed only 2/3 can per day instead of 1 and 1/2 or more.
OUTCOME
Dog active, no blood in the urine. Owner is happy.
Need to follow up to ensure compliance with C/D diet and check of urine for UTI and pH = 6.2 to 6.4.
It is time-consuming to follow up but owners don't comply and recurrence due to certain breed can recur again.
PHONED OWNER 10.35AM
1. Switch to dry C/D
2. Give 1 and 1/2 can of S/D per day for 20 kg bulldog till the switch to C/D.
2. No home-cooked rice or vegetables for at least next 6 months
3. Urine analysis every month.
Whether she will comply is up to her.
-----------------------------------------------------------------------------------------------------------------------------
X-rays in the previous first report: Blog No. 1186
is at:
http://2010vets.blogspot.sg/2012/11/1186-haematuria-in-british-bulldog.html and the report is reproduced below:
Monday, November 19, 2012
1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?
"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.
"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"
"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."
"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.
"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."
"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."
I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending.
SEE ABOVE CASE REPORT FOR DEC 2012 FOLLOW UP
An interesting multi-lobed large globular bladder stone was removed by Dr Daniel on Nov 26, 2012 and the stone is being analysed.
"My dog is OK but now passes stools every 2 days, as if she is constipated," the owner said. The dog used to eat like a horse.
"How many cans of S/D do you feed/day?" I asked as this 19 kg dog should be eating 1 and 1/2 to 1 and 3/4 cans per day.
"I feed 2/3 cans/day to prevent her from being fat."
"Do you feed dog treats, bread or other food?" I asked.
"Some vegetables and fruits, but only occasionally," she said.
COMPLIANCE ISSUESOwners don't comply with strictly feeding on prescription diet. They will give some treats, bread and fruits after a while.
REVIEWS FOR URINARY TRACT INFECTIONS
Owners don't do that.
1. To prevent struvites, urinary pH = 6.2 to 6.42. To prevent calcium oxalates, urinary pH = 7.1 to 7.73-weekly urine analysis is recommended but no Singapore owners do that. Breeds like Schnauzers and Shih Tzus have a tendency to get urinary stones and reviews of UTI will have prevented costly surgeries.
STRUVITES. Use C/D after stone removal. S/D is to dissolve the stones.
CALCIUM OXALATE. Use U/D to prevent more calcium oxalate stone formation. U/D does not dissolve the stones.
Check for urinary pH
CASE STUDY OF THE BRITISH BULLDOG
Nov 19, 2012. Blood in the urine for past 2-3 days. Urine analysis and X-rays (bladder stone).
Nov 26, 2012. Cystostomy to remove the stone. Bladder wall thickened. Dr Daniel put one appositional continuous suture on submucosal layer and one inverting suture. I advised an additional layer of inverting suture as that would be what I would do. A urinary catheter could be used via urethra to pump saline into the bladder to check whether there is leakage but for 3 layers, I know that the closure is secure.
URINE ANALYSIS 2 TIMES
Nov 19, 2012. pH 8.0, SG 1.020, Pn 2+, Blood 4+, WBC 30, RBC 720, Bacteria Nil, Crystals Nil (history of haematuria for past 3 days only).
Nov 26, 2012. pH 8.0, SG 1.019, Pn 3+, Blood 4+, WBC >2250, RBC >2250, Bacteria 3+, Crystals triple phosphate occasional (history of haematuria for past 10 days). The dog was on trimax and medazole oral for 10 days and baytril injection. S/D X6 cans were fed.
Antibiotic sensistivity test not done.
POST OP
Stone analysis pending.
Oral Baytril 2 days, trimax bid x 10 days
S/D given but owner fed only 2/3 can per day instead of 1 and 1/2 or more.
OUTCOME
Dog active, no blood in the urine. Owner is happy.
Need to follow up to ensure compliance with C/D diet and check of urine for UTI and pH = 6.2 to 6.4.
It is time-consuming to follow up but owners don't comply and recurrence due to certain breed can recur again.
PHONED OWNER 10.35AM
1. Switch to dry C/D
2. Give 1 and 1/2 can of S/D per day for 20 kg bulldog till the switch to C/D.
2. No home-cooked rice or vegetables for at least next 6 months
3. Urine analysis every month.
Whether she will comply is up to her.
-----------------------------------------------------------------------------------------------------------------------------
X-rays in the previous first report: Blog No. 1186
is at:
http://2010vets.blogspot.sg/2012/11/1186-haematuria-in-british-bulldog.html and the report is reproduced below:
Monday, November 19, 2012
1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?
"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.
"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"
"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."
"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.
"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."
"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."
I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending.
SEE ABOVE CASE REPORT FOR DEC 2012 FOLLOW UP
Monday, December 3, 2012
1201. Sunday Dec 2, 2012's interesting cases
Sunday Dec 2, 2012
A bright sunny Sunday morning. Yesterday, a hamster with a "quail-egg sized" swelling in the right pouch area was admitted by Dr Jason and referred to me. Before I left the surgery and handing over to Dr Jason, I saw a family bringing in a hamster.
I told him that tumours in hamsters should be passed to me if he does not want to operate to remove them. Giving medication would not reduce the big tumours. Some could be abscesses but they had to be lanced. This is the correct approach.
Mr Min showed me the dwarf hamster, 2 years old, male. He had the biggest ovoid lump as hard as a hard-boiled egg. "It could be an impacted food pouch on the right side," I said to Dr Daniel. "It is quite common. A broken seed could have lacerated the pouch and all the food got stuck inside."
We gave the hamster isoflurane gas inside a bottle. The hamster felt sleepy. I took a pair of forceps to evacuate the contents inside the right food pouch. Nothing came out. The hamster protested as he woke up quite easily under gas. Suddenly his eyes popped out from the sockets. "Stop every procedure," I said. "Let the hamster recover. Any handling may cause death."
After 5 minutes, Dr Daniel commenced gas anaesthesia and surgery. "Use the smallest scalpel blade and make a 0.5-cm cut on the skin," I had earlier asked Mr Min to clip off the hair and clean the area.
"It's a red tumour," I saw a bulging swelling under the skin. "Extend the incision to 1.5cm long and shell out the tumour. There is usually a large blood vessel supplying this tumour. Clamp "
A bright sunny Sunday morning. Yesterday, a hamster with a "quail-egg sized" swelling in the right pouch area was admitted by Dr Jason and referred to me. Before I left the surgery and handing over to Dr Jason, I saw a family bringing in a hamster.
I told him that tumours in hamsters should be passed to me if he does not want to operate to remove them. Giving medication would not reduce the big tumours. Some could be abscesses but they had to be lanced. This is the correct approach.
Mr Min showed me the dwarf hamster, 2 years old, male. He had the biggest ovoid lump as hard as a hard-boiled egg. "It could be an impacted food pouch on the right side," I said to Dr Daniel. "It is quite common. A broken seed could have lacerated the pouch and all the food got stuck inside."
We gave the hamster isoflurane gas inside a bottle. The hamster felt sleepy. I took a pair of forceps to evacuate the contents inside the right food pouch. Nothing came out. The hamster protested as he woke up quite easily under gas. Suddenly his eyes popped out from the sockets. "Stop every procedure," I said. "Let the hamster recover. Any handling may cause death."
After 5 minutes, Dr Daniel commenced gas anaesthesia and surgery. "Use the smallest scalpel blade and make a 0.5-cm cut on the skin," I had earlier asked Mr Min to clip off the hair and clean the area.
"It's a red tumour," I saw a bulging swelling under the skin. "Extend the incision to 1.5cm long and shell out the tumour. There is usually a large blood vessel supplying this tumour. Clamp "
1201. Follow up: The kidney-stone Schnauzer vomits again when at home.
"Unless the kidney is removed, it is not possible to prevent infections of the blood and urinary tract system," I said to the owner who had taken the dog back. The dog had a high total white cell count, blood and bacteria in the urine again. She was on intensive ciprobaby (twice) IV at 50ml/time (100 ml bottle) and had recovered during the past 3 days.
But she vomited again when she went home yesterday.She was active and Ok in the day time.
But she vomited again when she went home yesterday.She was active and Ok in the day time.
1199. Customised trained security dog services
Dec 3, 2012
Today, I met a 60-year-old retiree who accompanied her teenaged daughter to bring the 9-year-old Shih Tzu to me for general check up and vaccination.
"I have to ask my dad first as he is paying for the tests," the daughter said to me when I advised a blood and urine test for her old dog as part of health screening and this was not done before.
The dog had dental scaling done by Dr Vanessa last year and the teeth are OK, with some tartar formation. This dog does not permit his mouth to be opened and he showed his warning fangs when I attempted later. "He is a good natured dog as long as you don't touch his mouth," the girl told me. "He trembles and shakes when there is lightning and thunderstorm. A vet told us to ignore him but we hold him."
"You are fortunate that this dog does not pace and go into a frenzy during thunderstorms and lightning. He just shivers. Maybe de-sen. sitation using thunderstorm audio may help, by letting him listen regularly. But you may need to duplicate the change in temperature and humidity during thunderstorms and this cannot be done."
So, there was no solution.
However, the father has been working as a security consultant part-time, doing training programmes from his home. "Does he supply trained military guard dogs?" I asked her. "In Singapore, the system is to send staff from the police and army to Europe or USA to buy puppies and train them for narcotics and other duties by the local staff. The success rate is extremely poor. The staff has to travel far distances to see one or two puppies in various parts of Europe. I doubt the breeders really sell the good ones. Then, there is the allegation of staff corruption."
So, the girl's father could provide a niche service as his contacts in China can provide trained dogs according to the buyer's requirements. For example, if the Customs want 50 sniffler dogs, he can arrange for them to be delivered fully trained and tested by the Buyer. "This is a niche market," I said to the father.
"Not much business as Singapore and Malaysia don't buy many. A dog lasts 4 years and the Police may replace less than 10 per year."
"Well, this is a niche market to be developed by you since you have the training source and dogs in China," I said. "In the past, there is no such establishment and now you have the specialised dog training school, you can supply customised-trained dogs to anybody. Not only the army or the military. For example, a rich father may wish to get a guide dog for his blind child. This will be your niche market. You need to start your own company rather than use the present security company and build up your credibility and services."
The father could see the prospects. Whether he would be able to execute my idea, that is the million-dollar question. "It is more than 50% of the problems solved," I replied when he said that he already got the source of dog training school and the good relationship with the people there. "Very few if any Singaporean or Malaysian has this type of contact." Retirees in security business for many years have a large number of contacts if they know how to network with them to start a new business.
Today, I met a 60-year-old retiree who accompanied her teenaged daughter to bring the 9-year-old Shih Tzu to me for general check up and vaccination.
"I have to ask my dad first as he is paying for the tests," the daughter said to me when I advised a blood and urine test for her old dog as part of health screening and this was not done before.
The dog had dental scaling done by Dr Vanessa last year and the teeth are OK, with some tartar formation. This dog does not permit his mouth to be opened and he showed his warning fangs when I attempted later. "He is a good natured dog as long as you don't touch his mouth," the girl told me. "He trembles and shakes when there is lightning and thunderstorm. A vet told us to ignore him but we hold him."
"You are fortunate that this dog does not pace and go into a frenzy during thunderstorms and lightning. He just shivers. Maybe de-sen. sitation using thunderstorm audio may help, by letting him listen regularly. But you may need to duplicate the change in temperature and humidity during thunderstorms and this cannot be done."
So, there was no solution.
However, the father has been working as a security consultant part-time, doing training programmes from his home. "Does he supply trained military guard dogs?" I asked her. "In Singapore, the system is to send staff from the police and army to Europe or USA to buy puppies and train them for narcotics and other duties by the local staff. The success rate is extremely poor. The staff has to travel far distances to see one or two puppies in various parts of Europe. I doubt the breeders really sell the good ones. Then, there is the allegation of staff corruption."
So, the girl's father could provide a niche service as his contacts in China can provide trained dogs according to the buyer's requirements. For example, if the Customs want 50 sniffler dogs, he can arrange for them to be delivered fully trained and tested by the Buyer. "This is a niche market," I said to the father.
"Not much business as Singapore and Malaysia don't buy many. A dog lasts 4 years and the Police may replace less than 10 per year."
"Well, this is a niche market to be developed by you since you have the training source and dogs in China," I said. "In the past, there is no such establishment and now you have the specialised dog training school, you can supply customised-trained dogs to anybody. Not only the army or the military. For example, a rich father may wish to get a guide dog for his blind child. This will be your niche market. You need to start your own company rather than use the present security company and build up your credibility and services."
The father could see the prospects. Whether he would be able to execute my idea, that is the million-dollar question. "It is more than 50% of the problems solved," I replied when he said that he already got the source of dog training school and the good relationship with the people there. "Very few if any Singaporean or Malaysian has this type of contact." Retirees in security business for many years have a large number of contacts if they know how to network with them to start a new business.
Saturday, December 1, 2012
1198. A mother's sacrifice
Nov 30, 2012 was the last day of work for Dr Vanessa. I wished her well in her new venture as I had expected that she would be her own boss. She gave me a piece of chocolate cake to celebrate her birthday.
I had promised to send a Jack Russell with skin disease home at Lorong 8 Toa Payoh after treatment and clipping for skin itchiness. The domestic worker would wait at the first floor of the HDB block to take over the dog. I asked my intern (a young man in junior college year one) to put the dog in a crate. Min helped him. The owner had to go overseas and so I volunteered to send the dog back after grooming and bathing for the skin disease.
"It is the wrong dog," Dr Daniel phoned me. "There are 3 Jack Russells in the crates and you have got the one with the bladder stone."
Just a few days ago, the Kandang Kerbau Hospital had given the wrong babies to two mothers. One of the ankle name tags had fallen off and so the baby was given to the wrong mother. One of the two mothers discovered the mistake and there was needless worries and DNA checks. The private hospitals use RFID tags and so had no problem.
I may need to use RFID tags to identify the dogs but this would not be necessary as I don't have more than 10 dogs. Somehow, Min had given me the wrong dog. I asked the domestic worker to get permission from her employer to go back with me in the car to get the dog as the dog would bite. She got the permission via her phone and we went back to the Surgery to get the dogs.
"How long have you worked for the same employer?" I asked her.
"Twelve years," she surprised me as most workers don't stay more than 2 years.
"My employer is good," she said. "The dog is obedient too as he does not lick my face. He would look the other way. My religion does not permit me to touch dog saliva."
She walked the dog but does not feed him medication.
"Why do you work so many years?" I asked.
"To earn money for my children's education. My daughter is now grown up and is married. She will never be working as a maid like me."
Many maids made great sacrifices being away from families and going home 4 weeks every two years.so that the progeny can have a much better life.
I had promised to send a Jack Russell with skin disease home at Lorong 8 Toa Payoh after treatment and clipping for skin itchiness. The domestic worker would wait at the first floor of the HDB block to take over the dog. I asked my intern (a young man in junior college year one) to put the dog in a crate. Min helped him. The owner had to go overseas and so I volunteered to send the dog back after grooming and bathing for the skin disease.
"It is the wrong dog," Dr Daniel phoned me. "There are 3 Jack Russells in the crates and you have got the one with the bladder stone."
Just a few days ago, the Kandang Kerbau Hospital had given the wrong babies to two mothers. One of the ankle name tags had fallen off and so the baby was given to the wrong mother. One of the two mothers discovered the mistake and there was needless worries and DNA checks. The private hospitals use RFID tags and so had no problem.
I may need to use RFID tags to identify the dogs but this would not be necessary as I don't have more than 10 dogs. Somehow, Min had given me the wrong dog. I asked the domestic worker to get permission from her employer to go back with me in the car to get the dog as the dog would bite. She got the permission via her phone and we went back to the Surgery to get the dogs.
"How long have you worked for the same employer?" I asked her.
"Twelve years," she surprised me as most workers don't stay more than 2 years.
"My employer is good," she said. "The dog is obedient too as he does not lick my face. He would look the other way. My religion does not permit me to touch dog saliva."
She walked the dog but does not feed him medication.
"Why do you work so many years?" I asked.
"To earn money for my children's education. My daughter is now grown up and is married. She will never be working as a maid like me."
Many maids made great sacrifices being away from families and going home 4 weeks every two years.so that the progeny can have a much better life.
1197. Three teeth in a one-year-old dwarf hamster
Saturday Dec 1, 2012
The hamster with the swollen upper nose came back as she could not gnaw seeds. 4 days ago, Dr Daniel had incised the upper right area of the nose, draining the pus. Now, the lower right area of the nose below the right nostril had become more swollen. "The right nostril is bigger in diameter than the left," I said as the gentleman owner had complained that the hamster had sniffling sounds.
The hamster's upper right area was slightly swollen after drainage of the abscess. It took one month for the abscess to ripen and it was lanced 4 days ago on Nov 27, 2012. The lower right upper area had shown on pimple but was mainly hard as a rock. So, there was no point cutting it as it was not "ripe" meaning that the abscess had not come to a head.
The hamster squeaked when I tried to open the mouth with forceps but othewise was "sleepy" when hand-held by the girlfriend for me to take images of the inflamed area to document the condition. There would be another 4 days before this area would ripen and pus could be released. I scheduled Dec 4, 2012 to operate.
This hamster has only 3 teeth instead of 4. One right upper incisor and two lower incisor teeth with a gap between them.
"Was he born with 3 teeth?" I asked the gentlema as the hamster's front teeth grow continuously unlike human teeth. So a fractured one would grow back and the hamster wears out the teeth by gnawing and eating seeds..
"He had four teeth," he said.
"You dropped him when he was young," the girlfriend said.
Presently the hamster gained 5 g, from 40 g some 4 days ago after lancing the abscess. He would eat the bananna paste and loved the green jelly but could not chew on seeds or pellets for the past 4 days. So that was why the couple consulted me.
"He used to be 60 g," the man said.
"Once the abscess in the lower right area of the right nostril is soft and lanced, he will put on weight, befitting his name of "Ah Pui" (Fatty in the Hokkien dialect).
The hamster with the swollen upper nose came back as she could not gnaw seeds. 4 days ago, Dr Daniel had incised the upper right area of the nose, draining the pus. Now, the lower right area of the nose below the right nostril had become more swollen. "The right nostril is bigger in diameter than the left," I said as the gentleman owner had complained that the hamster had sniffling sounds.
The hamster's upper right area was slightly swollen after drainage of the abscess. It took one month for the abscess to ripen and it was lanced 4 days ago on Nov 27, 2012. The lower right upper area had shown on pimple but was mainly hard as a rock. So, there was no point cutting it as it was not "ripe" meaning that the abscess had not come to a head.
The hamster squeaked when I tried to open the mouth with forceps but othewise was "sleepy" when hand-held by the girlfriend for me to take images of the inflamed area to document the condition. There would be another 4 days before this area would ripen and pus could be released. I scheduled Dec 4, 2012 to operate.
This hamster has only 3 teeth instead of 4. One right upper incisor and two lower incisor teeth with a gap between them.
"Was he born with 3 teeth?" I asked the gentlema as the hamster's front teeth grow continuously unlike human teeth. So a fractured one would grow back and the hamster wears out the teeth by gnawing and eating seeds..
"He had four teeth," he said.
"You dropped him when he was young," the girlfriend said.
Presently the hamster gained 5 g, from 40 g some 4 days ago after lancing the abscess. He would eat the bananna paste and loved the green jelly but could not chew on seeds or pellets for the past 4 days. So that was why the couple consulted me.
"He used to be 60 g," the man said.
"Once the abscess in the lower right area of the right nostril is soft and lanced, he will put on weight, befitting his name of "Ah Pui" (Fatty in the Hokkien dialect).
1196. Spaying a dog at "6 months" of age
Saturday Dec 1, 2012
A young couple had made an appointment with me to examine their 6-month-old female dog before spaying next week. "Dr Vanessa has resigned from Toa Payoh Vets and her last day was yesterday," I said. "If you would like Dr Vanessa to spay your dog, you can contact her." Clients can have their personal preferences of the 4 vets at Toa Payoh Vets. Since it was Ok with them, I proceeded to examine the dog whose body was that of a cross between a Westie and a poodle. At 4-kg, whe could be considered suitable for spaying.
I opened the dog's mouth. Her temporary canine teeth were all white and narrow while her incisors were white and broad. "Your dog is less than 6 months of age," I said. "The permanent fangs or canine teeth will erupt at 5-6 months of age, pushing away the 4 puppy canine teeth. However, they have not yet erupted."
The couple was surprised as they were told by the sellers at Pasir Ris that the puppy - a MalteseXpoodle was 3 months old and that was 3 months ago.
"The likely explanation is that the AVA (regulatory authority) permits sale of puppies at 3 months of age. But younger puppies are more in demand and fetch a higher price. So, the puppy was sold at around 2 months of age." The vaccination certificate was not available. In any case, this puppy was less than 6 months of age.
"Can the dog be spayed at 5 months of age?" the lady asked.
"Yes," I said. "The animal welfare people sterilise them as young as 4 ,months of age. My advice is to spay her 2 months after her first heat to permit her private parts to develop fully to a msture state. But if you want to spay her before her first bleeding, 6 months of age would do." I showed the couple that this dog still had not develop the nipples. It would take time for her to mature.
"The vulval area is brownish," I said. "Is she licking her privte part? If she does, she may have a urinary tract infection."
I gave the couple a urinary bottle to collect urine for urine analysis as I could palpate a half-full bladder. "Clean the pee pan well and flush with water. When the dog pees there, collect 3 ml of the urine with this sterile syringe." The couple went home and came back soon with a bottle of yellow urine for analysis of bacteria.
"The last time she was checked by Dr Vanessa, the urine dipstick showed protein present," the young man said to me.
"A urine sample for analysis would be necessary to check for crystals, blood cells and bacteria."
Young vets must know when the permanent canine tooth erupts so as to estimate the age of young dogs. They erupt between 5-6 months, not 6-8 months, generally. In this way, they can estimate the age of the young dog.
A young couple had made an appointment with me to examine their 6-month-old female dog before spaying next week. "Dr Vanessa has resigned from Toa Payoh Vets and her last day was yesterday," I said. "If you would like Dr Vanessa to spay your dog, you can contact her." Clients can have their personal preferences of the 4 vets at Toa Payoh Vets. Since it was Ok with them, I proceeded to examine the dog whose body was that of a cross between a Westie and a poodle. At 4-kg, whe could be considered suitable for spaying.
I opened the dog's mouth. Her temporary canine teeth were all white and narrow while her incisors were white and broad. "Your dog is less than 6 months of age," I said. "The permanent fangs or canine teeth will erupt at 5-6 months of age, pushing away the 4 puppy canine teeth. However, they have not yet erupted."
The couple was surprised as they were told by the sellers at Pasir Ris that the puppy - a MalteseXpoodle was 3 months old and that was 3 months ago.
"The likely explanation is that the AVA (regulatory authority) permits sale of puppies at 3 months of age. But younger puppies are more in demand and fetch a higher price. So, the puppy was sold at around 2 months of age." The vaccination certificate was not available. In any case, this puppy was less than 6 months of age.
"Can the dog be spayed at 5 months of age?" the lady asked.
"Yes," I said. "The animal welfare people sterilise them as young as 4 ,months of age. My advice is to spay her 2 months after her first heat to permit her private parts to develop fully to a msture state. But if you want to spay her before her first bleeding, 6 months of age would do." I showed the couple that this dog still had not develop the nipples. It would take time for her to mature.
"The vulval area is brownish," I said. "Is she licking her privte part? If she does, she may have a urinary tract infection."
I gave the couple a urinary bottle to collect urine for urine analysis as I could palpate a half-full bladder. "Clean the pee pan well and flush with water. When the dog pees there, collect 3 ml of the urine with this sterile syringe." The couple went home and came back soon with a bottle of yellow urine for analysis of bacteria.
"The last time she was checked by Dr Vanessa, the urine dipstick showed protein present," the young man said to me.
"A urine sample for analysis would be necessary to check for crystals, blood cells and bacteria."
Young vets must know when the permanent canine tooth erupts so as to estimate the age of young dogs. They erupt between 5-6 months, not 6-8 months, generally. In this way, they can estimate the age of the young dog.
Tuesday, November 27, 2012
1195. British bulldog's cauliflower stone surgery
Nov 27, 2012
Yesterday morning, I mentored a bladder stone surgery on the female British bulldog, 4 years old. The dog is OK today.
Eats like a horse, the owner said. Home-cooked food and dry food. Yet, a big stone. The dog was on antibiotics and S/D diet for a week. "Can you guarantee the stone will dissolve by S/D diet?" the owner was tired of having to clean up the dribbling urine every few seconds. "My dog passes greyish urine yesterday, like ash." I said I doubt it. "So, it is better to operate. She has lost a lot of weight. Much lighter now."
I required a blood test and urine analysis on the day of surgery. This had been done before, my associate said. "It is best to monitor the latest situation."
SURGERY
Dr Daniel operated. I assisted.
I got syringe of urine direct from the bladder for urine analysis. Dark red brown urine.
Incision from apex of bladder 1.5 cm.
Thick bladder wall of 5 mm. Bloody.
Suturing. Continuous on mucosa, then 2 layers of inverting. 1 layer could be OK but I advised two layers.
BLOOD TEST RESULTS -Nov 26, 2012 on day of surgery
Total WCC 11.5 (6-19). N=89%, L=10%, M=1%, E=0, B=0
RBC and platelets normal. Urea and creatiine below normal.
URINE ANALYSIS- Nov 26, 2012 direct from the bladder
Red turbid, pH 8.0, SG 1.019, Protein 3+, Blood 4+, WBC >2250, RBC >2250
Crystals Triple phosphate occasioal, bacteria 3+
I did not request an antibiotic sensisitivity test to reduce costs.
Yesterday morning, I mentored a bladder stone surgery on the female British bulldog, 4 years old. The dog is OK today.
Eats like a horse, the owner said. Home-cooked food and dry food. Yet, a big stone. The dog was on antibiotics and S/D diet for a week. "Can you guarantee the stone will dissolve by S/D diet?" the owner was tired of having to clean up the dribbling urine every few seconds. "My dog passes greyish urine yesterday, like ash." I said I doubt it. "So, it is better to operate. She has lost a lot of weight. Much lighter now."
I required a blood test and urine analysis on the day of surgery. This had been done before, my associate said. "It is best to monitor the latest situation."
SURGERY
Dr Daniel operated. I assisted.
I got syringe of urine direct from the bladder for urine analysis. Dark red brown urine.
Incision from apex of bladder 1.5 cm.
Thick bladder wall of 5 mm. Bloody.
Suturing. Continuous on mucosa, then 2 layers of inverting. 1 layer could be OK but I advised two layers.
BLOOD TEST RESULTS -Nov 26, 2012 on day of surgery
Total WCC 11.5 (6-19). N=89%, L=10%, M=1%, E=0, B=0
RBC and platelets normal. Urea and creatiine below normal.
URINE ANALYSIS- Nov 26, 2012 direct from the bladder
Red turbid, pH 8.0, SG 1.019, Protein 3+, Blood 4+, WBC >2250, RBC >2250
Crystals Triple phosphate occasioal, bacteria 3+
I did not request an antibiotic sensisitivity test to reduce costs.
Thursday, November 22, 2012
1194. Follow up. The Schnauzer vomits again - bladder stones & kidney stones
Thur Nov 22, 2012
Vomited one month ago. Had kidney and bladder stones. I removed bladder stones, analysed as struvites. No vomiting for past month. On last Sat, came in as dog vomited. Warded. Vomited several hours after eating. Why?
Blood-borne infection. Urine has bacteria. Amorphous urate 2+. What's the cause and the solution?
X-rays today.
Spoke to a vet more senior than me. He said that very rarely did he encounter kidney stones. He had operated on one. "Very painful for the dog, need to give pain-killers post-op".
"Kidney stones occur in 4% of urinary stone cases, according to one Australian specialist vet presenting the SVA 2012 seminar," I said. "This vet said that if the incision of the kidney to remove the stone is more than 50% of the kidney length, the kidney would not function normally."
The X-ray showed the kidney stones to be more distinct. The dog had been on canned S/D diet for the past month and no other food. A lot of gas in the intestines. No stones in the bladder on V/D view. Is there any stone inside the ureter? This could partially obstruct the ureter and cause pain, nausea and vomiting hours after eating. The dog still eats and appears active. IV drips and antibiotics for the past 2 days. Wait and see.
Urine analysis revealed amorphous urates 2+ in urine pH 6.0, USG 1.017, blood 3+, bacteria 2+
Were the kidney stones of the left kidney URATES instead of struvites? It is hard to tell. Very rare cases of kidney stones seen by me for the past 40 years of practice.
UPDATES & MORE IMAGES AT WEBPAGE:
http://www.sinpets.com/F5/20121108vomiting_kidney_bladder_struvites_schnauzer_toapayohvets.htm
Vomited one month ago. Had kidney and bladder stones. I removed bladder stones, analysed as struvites. No vomiting for past month. On last Sat, came in as dog vomited. Warded. Vomited several hours after eating. Why?
Blood-borne infection. Urine has bacteria. Amorphous urate 2+. What's the cause and the solution?
X-rays today.
Spoke to a vet more senior than me. He said that very rarely did he encounter kidney stones. He had operated on one. "Very painful for the dog, need to give pain-killers post-op".
"Kidney stones occur in 4% of urinary stone cases, according to one Australian specialist vet presenting the SVA 2012 seminar," I said. "This vet said that if the incision of the kidney to remove the stone is more than 50% of the kidney length, the kidney would not function normally."
The X-ray showed the kidney stones to be more distinct. The dog had been on canned S/D diet for the past month and no other food. A lot of gas in the intestines. No stones in the bladder on V/D view. Is there any stone inside the ureter? This could partially obstruct the ureter and cause pain, nausea and vomiting hours after eating. The dog still eats and appears active. IV drips and antibiotics for the past 2 days. Wait and see.
Urine analysis revealed amorphous urates 2+ in urine pH 6.0, USG 1.017, blood 3+, bacteria 2+
Were the kidney stones of the left kidney URATES instead of struvites? It is hard to tell. Very rare cases of kidney stones seen by me for the past 40 years of practice.
UPDATES & MORE IMAGES AT WEBPAGE:
http://www.sinpets.com/F5/20121108vomiting_kidney_bladder_struvites_schnauzer_toapayohvets.htm
1193. Pus in the left eye - dwarf hamster
5759. Pus in an eye for the past 2 weeks
5760. No pus in an eye after 20 days of treatment
5761. No pus in an eye after 20 days of treatment
5762. Overview
Pus oozed out from the swollen conjunctiva. The whole left eye was badly infected. How to resolve this problem? Cutting up the abscess would be a calculated risk as the hamster might get blinded. Conservative treatment with eye drops and nursing needed 23 days. The hamster went home to a delighted little girl.
Webpage at:
http://www.sinpets.com/F6/20121123hamster_purulent_conjunctivitis_toapayohvets.htm
1192. Email query on tick control collar
On Wed, Nov 21, 2012 at 3:35 PM, Nicky @gmail.com> wrote:
Hi,
I have a golden retriever who is 4 years old and weighs 23kg. He is infested by ticks currently and is using the product "certifect". I would like to ask if I can use both the "Preventick Tick Collar" and "Certifect" together or do i have to use the 2 products separately?
Thank you very much.
Best regards,
----------------------------------------------
I am Dr Sing from Toa Payoh Vets. Certifect can be used separately. I have no knowledge of what "Preventtick Tick Collar" is as I don't use it.
Wednesday, November 21, 2012
1191. Guinea pig from Chua Chu Kang made resp.noises for the past 5 days
Wed Nov 21, 2012
At 7.30 pm, by appointment, the mother and two adult daughters brought the guinea pig, female, 4 years to consult me. "She makes noises like an engine for the past 5 days," the daughter said. "Now, she would not eat the pellets but just the vegetables. She would lie on the litter and not be moving. Liked to bite her lower part."
I checked the heart and lungs. Normal. No nasal or ocular discharge. Large ovoid shaped pellets passed. The coat was badly matted. The "noises" could be an upper respiratory infection or pain as the guinea pig tries to "de-matt" her clumps of coat in her back half.
I recommended Agnes who does guinea pig grooming. "How much?" the daughters asked.
Agnes said: "$40.00" but she was not free till the weekend. She explained to me she had to take care of her children. It is school holidays and she had some programmes. She had to fit in work-life balance with a brood of five children.
As for the guinea pig, the mother said she would come on Friday as she would be working. I said I would be in Malacca on a "Peranakan heritage tour" and so the older daughter said she would bring in the guinea pig on Thursday morning. She would wait while my assistant would clip off the coat and de-matt the hair.
The family had shifted from Ang Mo Kio to Chua Choa Kang in West Singapore and had taken so much trouble to come to consult me. Veterinary medicine is a very personalised service for many pet owners. The vet must stay the course for years as many younger vets come and go or work in various clinics and so could not be available.
At 7.30 pm, by appointment, the mother and two adult daughters brought the guinea pig, female, 4 years to consult me. "She makes noises like an engine for the past 5 days," the daughter said. "Now, she would not eat the pellets but just the vegetables. She would lie on the litter and not be moving. Liked to bite her lower part."
I checked the heart and lungs. Normal. No nasal or ocular discharge. Large ovoid shaped pellets passed. The coat was badly matted. The "noises" could be an upper respiratory infection or pain as the guinea pig tries to "de-matt" her clumps of coat in her back half.
I recommended Agnes who does guinea pig grooming. "How much?" the daughters asked.
Agnes said: "$40.00" but she was not free till the weekend. She explained to me she had to take care of her children. It is school holidays and she had some programmes. She had to fit in work-life balance with a brood of five children.
As for the guinea pig, the mother said she would come on Friday as she would be working. I said I would be in Malacca on a "Peranakan heritage tour" and so the older daughter said she would bring in the guinea pig on Thursday morning. She would wait while my assistant would clip off the coat and de-matt the hair.
The family had shifted from Ang Mo Kio to Chua Choa Kang in West Singapore and had taken so much trouble to come to consult me. Veterinary medicine is a very personalised service for many pet owners. The vet must stay the course for years as many younger vets come and go or work in various clinics and so could not be available.
1190. Follow up on Schnauzer with kidney & bladder stones
Wed Nov 21, 2012
The Schnauzer came back on Saturday as she had been vomiting the past 2 days. Blood tests revealed a high white cell count and urine test showed amorphous urates 2+ , blood, and white cells. The dog was on IV drip and antibiotics on day 1. She did not vomit. Ate food and vomited again yesterday.
It is possible that the kidney stones had caused this urinary tract infection. What is the solution? Cut out the stones from the kidney? Presently, a lot of pain in the abdomen. Bacterial infection is treated first and let the dog stabilise. X-rays will be needed.
The Schnauzer came back on Saturday as she had been vomiting the past 2 days. Blood tests revealed a high white cell count and urine test showed amorphous urates 2+ , blood, and white cells. The dog was on IV drip and antibiotics on day 1. She did not vomit. Ate food and vomited again yesterday.
It is possible that the kidney stones had caused this urinary tract infection. What is the solution? Cut out the stones from the kidney? Presently, a lot of pain in the abdomen. Bacterial infection is treated first and let the dog stabilise. X-rays will be needed.
1189. The Schnauzer scratches all over his body. Why?
Wednesday, November 21, 2012
1189. The Schnauzer scratches all over his body. Why?
Skin diseases are most common in practice. There are many causes and one of them is a lack of grooming as Singapore pet owners are harassed by the fast-paced city life.
In this 7-year-old male Miniature Schnauzer, his whole body, limbs and backside are itchy. The Schnauzer had a good coat until recently. He had not been to the groomer for some time. "My wife used to take care of him," the man in his late 40s told me that the dog had a good coat previously. The wife was no longer around and the dog developed generalised itchiness in the body, limbs, backside and ears. Hair loss over parts of the backside and legs.
A urinary tract infection was evident from the presence of blood and bacteria. The X-ray did not show any radio-dense stones. "There could be prostatitis," Dr Daniel discussed the case with me and had spoken to the owner about neutering. "Spermatozoa +++" was present in the urine analysis. This lab finding does occur and my hypothesis is that the male dog displayed hypersexuality. Neutering would certainly resolve his behavioral problem.
I noted that the prepuce was inflamed. It was possible that this male dog had relieved his pain from an inflamed or enlarged prostate. For some male dogs, neutering would prevent much prostate problems of inflammation and infection at the older age.
The dog has an excellent appetite as you can see lots of the dry dog food in the stomach and intestines.
A follow-up one month later would be advised.
1189. The Schnauzer scratches all over his body. Why?
Skin diseases are most common in practice. There are many causes and one of them is a lack of grooming as Singapore pet owners are harassed by the fast-paced city life.
In this 7-year-old male Miniature Schnauzer, his whole body, limbs and backside are itchy. The Schnauzer had a good coat until recently. He had not been to the groomer for some time. "My wife used to take care of him," the man in his late 40s told me that the dog had a good coat previously. The wife was no longer around and the dog developed generalised itchiness in the body, limbs, backside and ears. Hair loss over parts of the backside and legs.
A urinary tract infection was evident from the presence of blood and bacteria. The X-ray did not show any radio-dense stones. "There could be prostatitis," Dr Daniel discussed the case with me and had spoken to the owner about neutering. "Spermatozoa +++" was present in the urine analysis. This lab finding does occur and my hypothesis is that the male dog displayed hypersexuality. Neutering would certainly resolve his behavioral problem.
I noted that the prepuce was inflamed. It was possible that this male dog had relieved his pain from an inflamed or enlarged prostate. For some male dogs, neutering would prevent much prostate problems of inflammation and infection at the older age.
The dog has an excellent appetite as you can see lots of the dry dog food in the stomach and intestines.
A follow-up one month later would be advised.
Monday, November 19, 2012
1188. Sunday's interesting case - the cat with the balding backsides
Sunday Nov 18, 2012 Bright sunshine in the morning. Heavy downpour in the afternoon.
Case 1. Four months ago, this old male neutered cat was losing hair on both backsides. Balding patches. So I was rather surprised to see him with a full bloom of coat - freckled and thick. The Indian father and his adult graduate daughter came early in the morning to get some matted hair below the armpits removed. A complaint of itchy ears.
"He is such a nice cat," Dr Daniel commented. "He did not claw or scratch when his ears are cleaned."
"He is very timid when at the vet," the father said. "At home, he is a lion."
I really admired the thick coat and asked what happened. Many years the cat had baldness in the inguinal area and the coat was in a mess. I discovered it was the management of the litter box. The cat had dirtied himself when he went in and came out of the litter box which was lined with newspapers. What is the secret of his full coat? I reviewed my medical record of 4 months ago. The cat's anal sacs were infected and expressed and medication was given. An antifungal wash.
"Now we have 2 litter boxes," the father said. I can't remember whether it was my idea or not as I do not record every advice I gave and neither did I claim credit. "The cat would go into one to pee and one to poop. He would not go into any of the two till we clean it." So, that was the secret to such a lovely coat for this 8-year-old cat.
It was great to see this old cat having such a beautiful coat nowadays, considering that the father and daughter had so much worries over his balding backsides.
Case 2
A "gigantic" dog bigger than the Siberian Husky and more to the size of an Alaskan Malamute visited the clinic. His size was enough to send any lady or man into shivers. Like a big white wolf. He sniffed the door
Case 1. Four months ago, this old male neutered cat was losing hair on both backsides. Balding patches. So I was rather surprised to see him with a full bloom of coat - freckled and thick. The Indian father and his adult graduate daughter came early in the morning to get some matted hair below the armpits removed. A complaint of itchy ears.
"He is such a nice cat," Dr Daniel commented. "He did not claw or scratch when his ears are cleaned."
"He is very timid when at the vet," the father said. "At home, he is a lion."
I really admired the thick coat and asked what happened. Many years the cat had baldness in the inguinal area and the coat was in a mess. I discovered it was the management of the litter box. The cat had dirtied himself when he went in and came out of the litter box which was lined with newspapers. What is the secret of his full coat? I reviewed my medical record of 4 months ago. The cat's anal sacs were infected and expressed and medication was given. An antifungal wash.
"Now we have 2 litter boxes," the father said. I can't remember whether it was my idea or not as I do not record every advice I gave and neither did I claim credit. "The cat would go into one to pee and one to poop. He would not go into any of the two till we clean it." So, that was the secret to such a lovely coat for this 8-year-old cat.
It was great to see this old cat having such a beautiful coat nowadays, considering that the father and daughter had so much worries over his balding backsides.
Case 2
A "gigantic" dog bigger than the Siberian Husky and more to the size of an Alaskan Malamute visited the clinic. His size was enough to send any lady or man into shivers. Like a big white wolf. He sniffed the door
1187. The cat foster lady
"Sometimes, it is not the money but the shortage of time," I said to my associate vet who had amputated the kitten's left forelimb and had hospitalised it for 3 weeks. The wound did not heal well and the cat foster lady could not nurse the wound at home. So it was hospitalised here for some time.
2 evenings ago, the foster lady came to visit the cat after being absent for 3 days due to her workload. My associate vet had gone to visit the ailing grandma on that Friday evening and so I spent some minutes talking her. "Should the bandage be changed?" she asked me. "No need to change everyday," I said. The wound is healing by granulation. She usually spent time with the kitten till she had to go home. This time, the kitten peed onto her pink T-shirt. She went to the bathroom and changed to a floral one.
Today, Monday, Nov 19, 2012, the lady came. She was overjoyed when my associate vet released the cat to go home.
More Singaporeans are being kinder to stray cats and dogs now than 10 years ago. What happened to this stray kitten was that her left forelimb was paralysed. Her left eye cornea was 90% opaque and her right eye cornea had two large spherical bulges.
2 evenings ago, the foster lady came to visit the cat after being absent for 3 days due to her workload. My associate vet had gone to visit the ailing grandma on that Friday evening and so I spent some minutes talking her. "Should the bandage be changed?" she asked me. "No need to change everyday," I said. The wound is healing by granulation. She usually spent time with the kitten till she had to go home. This time, the kitten peed onto her pink T-shirt. She went to the bathroom and changed to a floral one.
Today, Monday, Nov 19, 2012, the lady came. She was overjoyed when my associate vet released the cat to go home.
More Singaporeans are being kinder to stray cats and dogs now than 10 years ago. What happened to this stray kitten was that her left forelimb was paralysed. Her left eye cornea was 90% opaque and her right eye cornea had two large spherical bulges.
1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?
"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.
"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"
"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."
"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.
"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."
"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."
I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending.
Sunday, November 18, 2012
1185. Audit Review of skin disease: The black Mini Schnauzer still bites her legs again
Sunday Nov 18, 2012 9.58 am
Skin diseases are due to many causes and each vet has his or her own way of diagnosis and treatment. Some cases need regular reviews monthly but rarely do owners bother to do it. Some cases get cured with one or two treatments. In the following audit case, I review the case treated by my associate vet in more detail as the owner came back again some 3 months later after the first treatment at Toa Payoh Vets on Nov 15, 2012 and as she spoke in Hokkien, I took over the case from the associate vet who could not speak a word of this dialect.
I was present on Nov 15 and saw her male friend shaking his head disapprovingly. "Your husband is shaking his head," I said. "He is a friend. I am a divorcee," she informed me. So, one must not presume spouses anytime. I asked for her history from the previous vet. There were 13 pages of record.
Today Sunday, I phoned the owner at 9.50 am. Nobody answered. Too early for a Sunday morning or she had gone out. Over 50 years old lady.
Mini Sch black, female, spayed
Skin diseases are due to many causes and each vet has his or her own way of diagnosis and treatment. Some cases need regular reviews monthly but rarely do owners bother to do it. Some cases get cured with one or two treatments. In the following audit case, I review the case treated by my associate vet in more detail as the owner came back again some 3 months later after the first treatment at Toa Payoh Vets on Nov 15, 2012 and as she spoke in Hokkien, I took over the case from the associate vet who could not speak a word of this dialect.
I was present on Nov 15 and saw her male friend shaking his head disapprovingly. "Your husband is shaking his head," I said. "He is a friend. I am a divorcee," she informed me. So, one must not presume spouses anytime. I asked for her history from the previous vet. There were 13 pages of record.
Today Sunday, I phoned the owner at 9.50 am. Nobody answered. Too early for a Sunday morning or she had gone out. Over 50 years old lady.
Mini Sch black, female, spayed
Saturday, November 17, 2012
Social media and google docs. Can old dogs learn new tricks?
Nov 17, 2012
To: Young new graduates - marketing your expertise in the social media is hard work
From: Dr Sing Kong Yuen
To: Young new graduates - marketing your expertise in the social media is hard work
From: Dr Sing Kong Yuen
Use google docs and social media to promote your expertise
The golden age of the internet is here. Yet, most young people don't know how to use the social media to promote their skills for prospective cients.
Gaming is fun and pleasure but will not create awareness of your hobbies, skills and expertise as a vet or hobbyists.
Facebook with pictures of fun and beer drinking and outrageous behaviour of the young undergraduates at school will make the their baby-boomer mothers blush, but actually such images cast the young persons involved as being lacking in self-discipline and morals and demonstrate irresponsibility to hold top management positions to prospective employers.
Use google docs to get your financial statements stored, rather than emailing attachments to the employer. The employer just click on the link with a password. This is what I mean by using social media to be more efficient, productive and smart in your profession.
With the new Samsung Notebook Lte, it is possible to write directly onto the phone-tablet. I can see this as a new way to record case studies by writing instead of typing on the keyboard and then storing the record in the cloud. Typing during consultation takes a lot of time and so this Samsung Notebook with pen will be an advance in medical recording, if you know how to apply the tools of the trade.
Gaming is fun and pleasure but will not create awareness of your hobbies, skills and expertise as a vet or hobbyists.
Facebook with pictures of fun and beer drinking and outrageous behaviour of the young undergraduates at school will make the their baby-boomer mothers blush, but actually such images cast the young persons involved as being lacking in self-discipline and morals and demonstrate irresponsibility to hold top management positions to prospective employers.
Use google docs to get your financial statements stored, rather than emailing attachments to the employer. The employer just click on the link with a password. This is what I mean by using social media to be more efficient, productive and smart in your profession.
With the new Samsung Notebook Lte, it is possible to write directly onto the phone-tablet. I can see this as a new way to record case studies by writing instead of typing on the keyboard and then storing the record in the cloud. Typing during consultation takes a lot of time and so this Samsung Notebook with pen will be an advance in medical recording, if you know how to apply the tools of the trade.
Read, research and apply the tools of social media to promote your expertise. It will be dull and boring compared to thumbing text messages to your friends and they thumb back trivial news to you, back and forth during your working hours. It is hard work and requires daily input on the blog, facebook or other social media. Few young ones will do it. So, this is where you distinguish yourself as a professional or hobbyists. Rarely do baby-boomer generation people do it but then they are set in their ways watching TVS or online movies and have no time to learn and apply new technologies to promote their expertise. Well, they are either established in their management positions or about to retire. Why would old dogs learn new tricks?
It is time to change your mindset if you want to distinguish yourself in this extremely competitive world where prospective clients are much more sophisticated and demanding of the highest standard of service at the lowest costs by surfing the internet.
It is time to change your mindset if you want to distinguish yourself in this extremely competitive world where prospective clients are much more sophisticated and demanding of the highest standard of service at the lowest costs by surfing the internet.
1183. Visual arts - artist
I rarely encounter artists as clients.
One of my clients is a visual artist.
Website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=35
Her father's website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=14
Many times, I can't figure out how an artist can earn a living as their art pieces need promotion, marketing, affordable pricing. Many don't seem to like to draw Singapore River scenes or local cultures as I presume there is no demand.
In some art exhibitions locally at the malls, some of such local scenes are good pieces of art but the prices are over $1,000.
It is time for the new artist to start their own website and display their artwork and pricing. But most don't do it and so the average man can see their artwork and can't buy their art pieces without having to go through an art gallery!
Lately Singapore has an "Affordable Art Fair".
Should young practising vets display their "artwork" which would be case studies with photos of before and after so that the prospective clients know what they are skilled at? Well, most don't do it. It is just too much time needed to do it!
One of my clients is a visual artist.
Website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=35
Her father's website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=14
Many times, I can't figure out how an artist can earn a living as their art pieces need promotion, marketing, affordable pricing. Many don't seem to like to draw Singapore River scenes or local cultures as I presume there is no demand.
In some art exhibitions locally at the malls, some of such local scenes are good pieces of art but the prices are over $1,000.
It is time for the new artist to start their own website and display their artwork and pricing. But most don't do it and so the average man can see their artwork and can't buy their art pieces without having to go through an art gallery!
Lately Singapore has an "Affordable Art Fair".
Should young practising vets display their "artwork" which would be case studies with photos of before and after so that the prospective clients know what they are skilled at? Well, most don't do it. It is just too much time needed to do it!
Friday, November 16, 2012
1182. Intense scratching of face and neck - poodle case review
Nov 16, 2011
I was reviewing a skin disease case and phoned the retired pharmacist.
"My poodle is OK now. 95% cured. Nibbles at front paws and will stop when I scold him."
"You can't be monitoring him 24 hours," I said. "Did you eat the Z/D diet?"
"He didn't like it, so I mix it with the usual dry dog food,"
Some info
Poodle, M, 4 years, landed property
Fed various brands of dry dog food
May 5, 2012
Itchy face, neck, paws, elbows. Skin scraping - no mites. No ringworm. Ears normal.
Medication and an anti-mite insecticide wash.
No further complaint.
Oct 20, 2012
Went to emergency night clinic.
Uncontrollable scratching of lower night all night until it bleeds.
Blood test normal. Skin scraping fungus and bacteria, no mites.
Hyperpigmented skin on ventral neck and dorsal surface of front paws - suggestive of chronic skin disease. Advised skin allergery/atopy workup.
Oct 21, 2012
Treated for bacteria and fungus. Canine Z/D trial for 3 months accepted by owner.
But the dog did not like it. So he did not give 100% when I phoned him on Nov 16, 2012 (today). He said the dog is 95% Ok with hair growth back to the areas. Except for front paws licking occasionally.
This case illustrated the great difficulty of some owners to do the Z/D food allergy elimination trial. "The dog is OK in the past 4 weeks," I said. "This is due to the medication. The real test will be the next 4 months. If you don't try the ZD, the dry dog food allergy may return once the drugs wear off."
Skin diseases are costly to treat but many owners don't realise the importance of review 4 weekly or the use of Z/D or equivalent food trials. The vet may need to keep a record and call the owner but we seldom do as we don't even have time to sit down.
Oct 21, 2012
Case came to me.
I was reviewing a skin disease case and phoned the retired pharmacist.
"My poodle is OK now. 95% cured. Nibbles at front paws and will stop when I scold him."
"You can't be monitoring him 24 hours," I said. "Did you eat the Z/D diet?"
"He didn't like it, so I mix it with the usual dry dog food,"
Some info
Poodle, M, 4 years, landed property
Fed various brands of dry dog food
May 5, 2012
Itchy face, neck, paws, elbows. Skin scraping - no mites. No ringworm. Ears normal.
Medication and an anti-mite insecticide wash.
No further complaint.
Oct 20, 2012
Went to emergency night clinic.
Uncontrollable scratching of lower night all night until it bleeds.
Blood test normal. Skin scraping fungus and bacteria, no mites.
Hyperpigmented skin on ventral neck and dorsal surface of front paws - suggestive of chronic skin disease. Advised skin allergery/atopy workup.
Oct 21, 2012
Treated for bacteria and fungus. Canine Z/D trial for 3 months accepted by owner.
But the dog did not like it. So he did not give 100% when I phoned him on Nov 16, 2012 (today). He said the dog is 95% Ok with hair growth back to the areas. Except for front paws licking occasionally.
This case illustrated the great difficulty of some owners to do the Z/D food allergy elimination trial. "The dog is OK in the past 4 weeks," I said. "This is due to the medication. The real test will be the next 4 months. If you don't try the ZD, the dry dog food allergy may return once the drugs wear off."
Skin diseases are costly to treat but many owners don't realise the importance of review 4 weekly or the use of Z/D or equivalent food trials. The vet may need to keep a record and call the owner but we seldom do as we don't even have time to sit down.
Oct 21, 2012
Case came to me.
Subscribe to:
Posts (Atom)